ANDHRA PRADESH MODEL SCHOOLS

ANDHRA PRADESH:: IBRAHIMPATNAM, VIJAYAWADA

ADMISSION TEST INTO VI CLASS 2020-2021

Personal Details
1 Reference Id : 20005410
2 Surname : BOYA
3 Candidate Name : BOYA MAMATHA
4 Aadhar Number : 898579878481
5 Father Name : BOYA SEKHAR
6 Mother Name : BOYA ANJINAMMA
7 Date of birth : 5/4/2010
8 Gender : Female
9 Address : 3-132, PAIGERI , GAJULADINNE VILLAGE
GONEGANDLA MANDAL , Mandal :
Gonegandla
District : KURNOOL , Pin: 518463
10 e-Mail : m.b.bheemasekhar@gmail.com
11 Mobile : 9014345227
12 Reservation Category : BC-A
13 SubCaste : BOYA
14 Whether the Annual Income of Parent is Yes
below Rs.60,000 :
15 Are you a Physically Handicapped(PH) No
Person :
School applying for
16 District : KURNOOL
17 Mandal : GONEGANDLA
18 School : GAJULADINNE
19. Education Details
S. No Year Of Study Class in which Medium of District in whether the whether the
Studied/Studyi study which school of School is School is
ng study is located (Govt./Govt located in
( District Name) Aided/ Govt Rural/Urban
Recognized)
1. 2018-2019 4th Class TELUGU KURNOOL Govt Rural
2. 2019-2020 5th Class TELUGU KURNOOL Govt Rural
20.Payment Details
Fee Amount Journal Number Payment Date
100 /- SUR28976167007 08/07/2020
DECLARATION
The information furnished above is true and to the best of my knowledge. I will produce the original certificates
as and when asked by the Department at the time of Admission. I am aware that any wrong information furnished by
me disqualifies my selection automatically

Signature of the Parent

Signature of the candidate.

NOTE: After Submission of online application the same print copy for admission must be submitted to the concerned
Principal of Andhra Pradesh model school in which the candidate is seeking admission.
Sd/-
BOYA MAMATHA ,08-07-2020 08:05:10 PM