Velammal Global School Puzhal

Cambridge Primary / Lower Secondary Checkpoint Assessments

Declaration form AY 21 22
Dear Parents,
Kindly fll the following details of Cambridge Checkpoint Assessments for the AY 2021-22.

Assessment Name:
Cambridge Primary Checkpoint Assessments for Gr 5 &6
Cambridge Lower Secondary Checkpoint Assessments for Gr 8

Candidate Name: (as per Birth certificate/

previous school TC - Need attachment as a

proof of correct name) Mon Mauiggmdan.NH

Class:

Centre Number: INO89

Date of Birth: (use of format DDMMYYYY)

30 Os 209
Gender: (MIÁ
M
Nationality: (In case Foreign Nationality-
Need to submit Foreign Nationality
certificate)
nd iasn
Date
20 2
Cambridge Primary/ Lower Secondary Checkpoint
Name of the Assessment: (Select any one) Assessments

Fee amount in Rs.

9200/
Parent's Name:
Haz bbu)
Contact Number:
994035o910
I confirm that the above mentioned details are correct and I have submitted proper evidence (Birth Cetificate/
Previous School TC Copy) to confirm the same.

Parent's Name: Ha auI

o zz
Signature with Date:

Exams Officer Academic Coordinator

HOS& Centre Head