G0VERNMENT OF KERALA

DIRECTORATE OF GENERAL EDUCATION (HIGHER SECONDARY WING)

APPLICATION FOR ADMISSION TO THE HIGHER SECONDARY COURSE (2O23-2O24)
APPLICATION NO: 2307104348

Name: NIDHIN VARGHESE Guardian Name: VARGHESE MATHEW

Mother's Name: ANU P KURIAN Father's Name: VARGHESE MATHEW

Date of Birth: 03-08-2007 Sex: Male

Aadhaar No: 327XXXXXX284 Enrolement No: -

Board Passed: Yes Scheme: SSLC (2022-2023) Register Number: 256788

Month of Pass: 3 Year of Pass: 2023

Category Name: General OEC: No

Caste: JSC Religion: Christian

Resident State: Kerala Resident Local Body: Angamali(M)

Resident District: Ernakulam Resident Taluk: Aluva

Permanent Address: KOORAN (H) YORDHANAPURAM P O KALADY Communication Address : KOORAN (H) YORDHANAPURAM P O KALADY

MATTOOR,ERNAKULAM 683574 MATTOOR,ERNAKULAM 683574

EWS Reservation: No

Blind: No Deaf No OH: No

IEDC : - MR/Brain Diseases: No Health Club: No

Linguistic Minority: No Minority Language: Jawan Killed In Action: No

Jawan Priority: No NCC or Scout / Guide(Puraskars) Yes Scout / Guide Participation : No

NTSE Qualified: No NMMSSE Qualified: No USSE Qualified: No

LSSE Qualified: No Student Police Cadet: No Red Cross: No

Forestry Club: No Environment/Nature Club: No IT Club: No

Maths Club: No Debating Club: No Philatery Club: No

Oratory Club: No Science Club: No Social Science Club: No

Grace Mark Awarded: No Little KITES Members With A Grade: No

SPORTS AND YOUTH FEST SL-I D-I / A D-II / B D-III / C DLP STATE FAIRS A-Grade B-Grade C-Grade D-Grade E-Grade

Sports Fest 0 0 0 0 0 State Science Fair 0 0 0 0 0

Youth Fest 0 0 0 0 0 State Social Science Fair 0 0 0 0 0

E-Mail ID: [email protected] State Maths Fair 0 0 0 0 0

Phone Number: 9074866642 State IT Fair 0 0 0 0 0

Chance Number: 1 State Work Experience Fair 0 0 0 0 0

SSLC School: 7215 Mar Agustins HSS, Thuravur

State Level First(SL-I), District First or A-Grade(D-I / A), District Second or B-Grade(D-II / B), District Third or C-Grade (D-III / C), District Level Participation(DLP)

CANDIDATE GRADE DETAILS

PAPER NAME MARK GRADE GRADE POINT

First Language- I NA A+ 9

First Language- II NA A+ 9

English NA A+ 9

Hindi NA A+ 9

Social Science NA A+ 9

Physics NA A+ 9

Chemistry NA A+ 9

Biology NA A+ 9

Mathematics NA A+ 9

Information Technology NA A+ 9

IT Services : NIC Kerala Page 1 / 2 IP : 103.194.69.244 - Date & Time : 02/06/2023 05:11:19 PM
 CANDIDATE OPTION DETAILS (MAIN)

Pref School Code Course Pref School Code Course Pref School Code Course Pref School Code Course

No. Code No. Code No. Code No. Code

1 7028 5 2 7048 5 3 7214 5

CLAIMED CERTIFICATE DETAILS

CERTIFICATE NAME CERTIFICATE NO CERTIFICATE DATE ISSUING AUTHORITY

NCC or Scout/Guide (Rashtrapathi Puraskar or Rajya ALV/S/3101/2023 04-03-2023 The Bharat Scouts and Guides

.......................................................................................................................................................................................................
DECLARATION
I VARGHESE MATHEW, Parent of Master/Kumari NIDHIN VARGHESE do hereby declare that all the information furnished
in the application are true to the best of my belief. I know that the allotment got by any false information furnished in the application
will results in the cancellation of Allotment and Admission.

Name and Signature of Parent/Guardian

Place :
Date : 02-06-2023

IT Services : NIC Kerala Page 2 / 2 IP : 103.194.69.244 - Date & Time : 02/06/2023 05:11:19 PM