G0VERNMENT OF KERALA

DIRECTORATE OF GENERAL EDUCATION (HIGHER SECONDARY WING)

APPLICATION FOR ADMISSION TO THE HIGHER SECONDARY COURSE (2O23-2O24)
APPLICATION NO: 2301116999

Name: GOPIKA KRISHNAN. K Guardian Name: SHIJINI. I.V

Mother's Name: SHIJINI. I.V Father's Name: KUMAR. K

Date of Birth: 23-03-2007 Sex: Female

Aadhaar No: 287XXXXXX926 Enrolement No: -

Board Passed: Yes Scheme: SSLC (2022-2023) Register Number: 126637

Month of Pass: 3 Year of Pass: 2023

Category Name: EzhavaThiyyaBillava (ETB) OEC: No

Caste: EZHAVA Religion: Hindu

Resident State: Kerala Resident Local Body: Nanniyode

Resident District: Thiruvananthapuram Resident Taluk: Nedumangad

Permanent Address: GOKULAM, CHONANVILA MEENMUTTY PO Communication Address : GOKULAM, CHONANVILA MEENMUTTY PO

695562,THIRUVANANTHAPURAM. 695562,THIRUVANANTHAPURAM.

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) No 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: Yes Social Science Club: No

Grace Mark Awarded: Yes 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: - State Maths Fair 0 0 0 0 0

Phone Number: 6282305569 State IT Fair 0 0 0 0 0

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

SSLC School: 1175 SKVHSS, Nanniyode

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 : 137.97.118.199 - Date & Time : 15/06/2023 08:30:49 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 1175 1 2 1071 1 3 1145 1 4 1032 1

CLAIMED CERTIFICATE DETAILS

CERTIFICATE NAME CERTIFICATE NO CERTIFICATE DATE ISSUING AUTHORITY

Science Club 32 28-02-2023 SKV HSS NANNIYODE

.......................................................................................................................................................................................................
DECLARATION
I SHIJINI. I.V, Parent of Master/Kumari GOPIKA KRISHNAN. 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 will
results in the cancellation of Allotment and Admission.

Name and Signature of Parent/Guardian

Place :
Date : 15-06-2023

IT Services : NIC Kerala Page 2 / 2 IP : 137.97.118.199 - Date & Time : 15/06/2023 08:30:49 PM