CLASS XI EXAMINATION FORM 2020-21

(For Class XII Board Examination 2021-22)

“Form for mandatory filling of details of candidate duly signed by candidate/ parents and teacher”

Admission No. 7010 Date of Admission

SHREESANTH IYER
Candidate Name ( In
capital letters)

LT COL SANDHYA VELAYUDHAN

Mother’s Name( In
capital letters)

ASHOK KUMAR IYER

Father’s Name( In
capital letters)

03/01/2006 (Male/Female/Transgender) MALE

SEX
Date of Birth

Caste (GEN/OBC/SC/ST) GENERAL Handicap (YES/NO) NO

Annual Income

Only Child (YES/NO) NO Minority (YES/NO) NO

Mobile Number 9878538548
Email Id asokiyer@gmail.com
Aadhar No. 3434 2664 1560
MATHEMATICS AND BIOLOGY
Optional Subjects in class
XI
Class X Roll No 20193354
Class X (Year of passing) 2021
Class X (Board) CBSE
Undertaking
I have thoroughly checked all the details as above filled in for registration of class XI Examination in
respect of my ward. I would not request for any change in the details filled in the Examination form of my
ward such as date of birth, Candidate Name/Mother’s Name, Father’s Name etc. If any mistake in student
credential is detected before/ after declaration of result, I will be solely be held responsible for the same.

Signature of Father: Signature of Mother:

Signature of Student: Signature of Class Teacher:

Date: Signature of School Principal:

Note: This form is to be preserved by the school for purpose of verification by Board at any stage.