G0VERNMENT OF KERALA
DIRECTORATE OF GENERAL EDUCATION (HIGHER SECONDARY WING)
APPLICATION FOR ADMISSION TO THE HIGHER SECONDARY COURSE (2O2O-2O21)
APPLICATION NO: 19023589
Name: MUHAMMED SAJAD. K Guardian Name: K. ABDUL MAJEED
Mother's Name: K. KHADEEJA Father's Name: K. ABDUL MAJEED
Date of Birth: 27-09-2004 Sex: Male
Aadhaar No: 309XXXXXX075 Enrolement No: -
Board Passed: Yes Scheme: SSLC (2019-2020) Register Number: 291951
Month of Pass: 3 Year of Pass: 2020
Category Name: Muslim OEC: No
Caste: MUSLIM Religion: Islam
Resident State: Kerala Resident Local Body: Others
Resident District: Others Resident Taluk: Others
Permanent Address: KANDAPPATH, CHELAKKAD CHELAKKAD PO, Communication Address : KANDAPPATH, CHELAKKAD CHELAKKAD PO,
679323, MALAPPURAM 679323 679323, MALAPPURAM 679323
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Blind: No Deaf No OH: No
IEDC : - MR/Brain Diseases: No Health Club: No
Linguistic Minority:
Jawan Priority:
NTSE Qualified:
No
No
No
Minority Language:
NCC or Scout / Guide(Puraskars)
Science Club:
O
No
No 2
Jawan Killed In Action:
Scout / Guide Participation :
Social Science Club:
No
No
Yes
2
Forestry Club: No Nature Club: No IT Club: Yes
Maths Club: Yes Debating Club: Yes Philatery Club: No
Oratory Club:
Red Cross:
No
No
Lit Con(School Magazines):
Student Police Cadet:
- No
No
Lit Con (Periodicals):
Swim:
No
Yes
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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
A
Youth Fest 0 0 0 0 0 State Social Science Fair 0 0 0 0 0
E-Mail ID: - State Maths Fair 0 0 0 0 0
C
Phone Number: 9961668025 State IT Fair 0 0 0 0 0
Chance Number: 1 State Work Experience Fair 0 0 0 0 0
SSLC School:
PAPER NAME
First Language- I
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9038 P T M YATHIMKHANA HSS, EDAPPALAM, PALAKKAD
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)
h CANDIDATE GRADE DETAILS
MARK
NA
GRADE
B
GRADE POINT
First Language- II NA B 6
English NA C+ 5
Hindi NA C 4
Social Science NA C+ 5
Physics NA C+ 5
Chemistry NA A 8
Biology NA C+ 5
Mathematics NA B 6
Information Technology NA A 8
IT Services : NIC Kerala Page 1 / 2 Date & Time : 02/08/2020 08:33:48 AM
CANDIDATE OPTION DETAILS
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 9038 1 4 9038 39 7 9084 1
2 9038 5 5 9154 10 8 9084 36
3 9038 10 6 9154 1 9 9084 39
CLAIMED CERTIFICATE DETAILS
CERTIFICATE NAME CERTIFICATE NO CERTIFICATE DATE ISSUING AUTHORITY
Social Science Club 2019-20 ACADEMIC YEAR 04-07-2020 P.T.M.Y.H.S.S EDAPPALAM
Debating Club 2019-20 ACADEMIC YEAR 04-07-2020 P.T.M.Y.H.S.S EDAPPALAM
Maths Club 2019-20 ACADEMIC YEAR 04-07-2020 P.T.M.Y.H.S.S EDAPPALAM
IT Club 2019-20 ACADEMIC YEAR 04-07-2020 P.T.M.Y.H.S.S EDAPPALAM
Swimming SPORTS COUNCIL 2020 08-07-2020 PULAMANTHOLE GRAMA PANCHAYAT
.......................................................................................................................................................................................................
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DECLARATION
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I K. ABDUL MAJEED, Parent of Master/Kumari MUHAMMED SAJAD. K 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
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will results in the cancellation of Allotment and Admission.
Name and Signature of Parent/Guardian
Place :
Date : 02-08-2020
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A P
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IT Services : NIC Kerala Page 2 / 2 Date & Time : 02/08/2020 08:33:48 AM
