wix,, SRI BASARA JUNIOR COLLEGE (02016) (Re No. 221480/E4-4/2007-08 Dt. 17-7-2007) Regd. by Govt. cf Andhra Pradesh, Vijayawada Old Dairy Farm, Behind Petrol Bunk, Greater Visakhapatnam - 530 040 FORM OF THE TRANSFER CERTIFICATE FOR INTERMEDIATE COURSE Original Transfer Certificate No : 1 oe een 10. 11. 12. 13. 14. 15. 16. Ate 18. 000669 Name of the Junior College (Place and District) Name of the Pupil Name of the Parent or Guardian Name of the Mother Nationality and Religion ‘Whether the cancidate belongs to S.Cs., or S.Ts or Vimuktha Jathis or other Socially and Edcationally Backward Class specified inA.PLLE. Rule or is he / she a convert from the S.Cs or the $.1s, if so the particulars therefore Date of Birth (in words) a) Class in which the pupil was studying at the time of leaving (in words) b) First language under Part | ¢) Second janguaye under Part tt 4) Optional Under Part til Mother tongue and Medium of Instruction Date of admission to 1st year intermediate Course (the year to be entered in words) Class and Year in which the pupil was first admitted into the intermediate Courses (1st Year or 2nd Year) Whether qualified to study Il Year Class or intermediate Course? (in case of students leaving after completing 1st Year Class) ‘Whether the pupil has been declared eligible by the Board of Intermediate Education for University Course or Study a) Whether the pupil was in receipt of any scholership? (Nature of the concession to be specified) Personal marks of identification Date on which the pupil has actually left the college Date of Transfer Certificate Conduct ‘Academic Yeat Date: D1 O6-26|9 Admission No = SRI BASARA JUNIOR COLLEGE (02016). Visakhapatnam BONU DILEEP KUMAR BONU NARASIMHA MURTHY BONU SURYA KUMAR! Indian - Hindu BC - D (Koppulavelama - SI.No. 16) 28-07-2002 Senior Intermediate English Sanskrit Botany - Zoology - Physics - Chemistry Telugu - English Medium 18-06-2017 Junior Intermediate YES YES As per SSC As per SSC 31-03-2019 0 [- 06-2014 PR eB vy oN