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ANNEXURE –I

Format: CBSE Expression Series Submission Form

(You need to write all these details on the each sheet you use for submitting the entry.)

Fill all details. All fields are mandatory: Name of Participant: Smruti Shikha
Priyadarsihini Class: III Section C Gender: M/ F / Other Differently Abled: Yes/ No(tick
one) Name of the School with complete address: Dr. ANK DAV Public School, Basanti Colony
. Rourkela -12, Sundargarh, Odisha
Name of City/Village: Rourkela State: Odisha Contact Number of participant/parent
(whichever is applicable):9337437552 Contact No. of School 9040542458 Email address of
participant(whichever is applicable): aj.arijita@gmail.com .

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