You are on page 1of 1

Vandemataram Foundation

PALAMOOR PRAGNADHAMAM

Application Form
Full Name: ________________________________________________________________________

Father’s Name: _____________________________________Occupation:__________________


Photo
Mother’s Name:_____________________________________Occupation:__________________

Income per annum: _______________________ Caste: _________________________________

Date of birth: ____________________________ Age: ___________________________________

10th Class marks: ___________________________ Percentage: _________________________

School Address: __________________________________________________________________________________________

__________________________________________________________________ PIN Code: ______________________________

House Address: ___________________________________________________________________________________________

__________________________________________________________________ PIN Code: ______________________________

Phone No.:_________________________________________________________________________________________________

Head Master’s Name: _______________________________________________ Phone : ______________________________

−dsV NRPVÈÁVLiÊÁ xmsLjizqós¼½ ¾»½ÖÁzqs©«s BµôR¶LRiV ÉÔÁ¿RÁLýRi }msLýRiV, Fn¡©±s ©«sLiÊÁLýRiV


1) ___________________________________________________________ Fn¡©±siM _____________________
2) ___________________________________________________________ Fn¡©±siM _____________________
ÇÁ»R½Â¿Á[¸R¶Vª«sÌÁzqs©«s xmsú»yÌÁVM
1) xmsµR¶ª«s»R½LRigRi¼½ ª«sWLRiVäÌÁ ®ªsV®ªsW
2) lLi[xtsQ©±s NSLïRiV
3) −dsV »R½ÖýÁµR¶Liú²R¶VÌÁ»][ −dsVLRiV úxmsxqsVò»R½Li DLiÈÁV©«sõ BLiÉÓÁ úxmsµ³y©«s µy*LRiLi ª«sVVLiµR¶V ¬sÌÁÊÁ²T¶ µj¶gji©«s Fn¡ÉÜ[
gRiª«sV¬sLi¿RÁLi²T¶:-
1) ®ªsVLjiÉÞ D©«sõ @©yµ³R¶ÌÁNRPV ®ªsVVµR¶ÉÓÁ úFyµ³y©«sù»R½, »R½ÖýÁ gS¬s »R½Liú²T¶ gS¬s ÛÍÁ[¬s ®ªsVLjiÉÞ D©«sõ zmsÌýÁÌÁNRPV lLiLi²R¶ª«s úFyµ³y©«sù»R½, ®ªsVLjiÉÞ D©«sõ
¬sLRiV}msµR¶ zmsÌýÁÌÁNRPV ª«sVW²R¶ª«s úFyµ³y©«sù»R½.
−sª«sLSÌÁNRPV xqsLiúxmsµj¶Li¿RÁLi²T¶.
$ ª«sWµ³R¶ª«slLi²ïT¶ ¸R¶V²R¶ø,
NSLRiùµR¶Lji+, ª«sLi®µ¶[ª«sW»R½LRiLi Fn¢Li®²¶[xtsQ©±s.
Head Master’s signature & Stamp
Phone: 94407 88282

*−sµyùLóRiVÌÁ FsLizmsNRP ¬sLñRi¸R¶VLi xmspLjiògS FyÌÁª« s VWLR i V úx m sÇì Ø µ³ y ª« s VLi |qsÛÍÁOR P Q©± s NR P −sVÉÓ Á ®µ¶ [ .
−dsV NRPVÈÁVLiÊÁ xmsLjizqós¼½ gRiVLjiLiÀÁ xqs−sª«sLRiLigS }msÒÁ[ ®ªs©«sVNRP úªy¸R¶VLi²T¶.