नवोदय िव ालय सिमित

Navodaya Vidyalaya Samiti

( An Autonomous Body Under Ministry of Education) Government Of India

Registration No. 10060502483

Personal Detail

District in which the

candidate is studying in
class V(2020-21)
State in which the candidate is
KARNATAKA SHIMOGA
studying in class V(2020-21)
Candidate is eligible for admission only in
th same district

Name of the School in which

Block in which the candidate is KENDRIYA
SHIMOGA the candidate is studying in
studying in class V(2020-21) VIDYALAYA
class V(2020-21)

Name of the Candidate

PRATEEKSHA N
(Name as on class V certificate)

Mother's Name RADHIKA B Father's Name NAGARAJ

Relationship with Guardian

Name of the Guardian (Optional)
(Optional)

A BLACK DOT
Nationality of the Candidate INDIAN Identification Mark ON RIGHT
SIDE CHEEKS

Gender Female Category(GEN/SC/ST/OBC) ST

Medium of Examination*
(JNVST question paper will be English Date Of Birth 16/10/2009
provided in this language only)

Disability,if any
(Less than 40% will not be None Disability Percentage NA
accepted)

If Others, please specify the

Religion Hinduism
Religion

Aadhar Number Annual Income of Parents 20000

Communication Details

Present Postal Co BASAVARAJAPPA, PinCode 577233

Address(Residential Address is ATTIGUNDA,
collected ARALIHALLI POST.
only for official correspondence BHADRAVATHI TALUK
purpose. However
the District of class V study is the
criteria for
Registration/Selection/Admission)

Residential State KARNATAKA Residential District SHIMOGA

Telephone - Mobile No. 8197296042

EmailID radhikashree4607@gmail.com

Previous School Detail

V Standard
III Standard Details IV Standard Details
Details

Name of the State KARNATAKA KARNATAKA KARNATAKA

Name of the District CHITRADURGA SHIMOGA SHIMOGA

Name of the Block HOLALKERE SHIMOGA SHIMOGA

Name of the Village HOLALKERE SHIMOGA SHIMOGA

VAGDEVI
INDO KIDS HIGHER KENDRIYA
Name of the School INTERNATIONAL
PRIMARY SCHOOL VIDYALA
RESIDENTIAL SCHOOL

Recognized/ Not Recognized Recognized Recognized Recognized

School Location Urban Urban Urban

Year/Month of Joining May/ 2018 May/ 2019 September/ 2020

Year/Month of Passing April/ 2019 April/ 2020

Candidate Photo Candidate Signature

Parent Signature Certificate