JAWAHAR NAVODAYA VIDYALAYA SELECTION TEST-2023

STUDY CERTIFICATE
Last date of submission of
online application form is 31 January 2023
Certifled that the information gpiven befow are oorrect in
respect of MY KNOWLEDGE
(Name
of Student) whoia studying in
Class V in AVNSDAIVAGZNA
(Name of Schoo) and interested to
apply for Jawahar Navodaya
Vidyalaya Selection Test 2023
Name of Candidate ((N BL00K LETERS)
ATHMAKURU VENKATA NAGASAI
Father's Nome (N BLOCK DAIVAGZNA
LETTERS)
ATHMAKURU SUNILKUMAR
AMother's Name (NBLOCK
LETTERS)
ATHMAKURU VASANTHA LAKSHMI
Name of the Guardian
and
relationship, any. A SUNIL KUMAR
if

(FATHER)
Date of Birth

in words ZEROTHREE.ZERO TWO

TWO ZERO ONE THREE
Gender
Boy
Please put Girl
Transgender en OBC ST
Vmark

Nature of
disability, if
any

.
Physically
Peaie
put V in he repective Visually Hearing % of Disability
catrgory

Aadhaar Number

Address: 3-134,
of the candidate:

L724690 24 3 S5
E-mail
CHINARAVURUV).TENALI(M)
Suniikumar.athmakuru@gmail.com
(A.P)522201Mobile92
dentification mark of
9 67 o 837 1

Annual Income Candidate MOLE ON RIGH HAND SRD FUO

1,08000- IND1AN
Medium of Examination
Nationality
Religion HINOU
Particulars
ENGLLSH (Please indicate one language for the state concerned given in the prospectus)

Class-Ill
Name of the School Class-IV
Class-V
(studied-Il & IV and
V) and NIRmA LA HI6H NIRMALA KA MoDC
Studying
village/place SCHOOL HIGH|VIvE
ATMAKUR SCHOoL ScHOoL
School Location: Rural
/Urban
RURAL ATMA KUR ANGALKUDURU
Month and Year
Month &
of Joining

APRIL202 RURAL Ru RAL

year of
2021 APRIL
MARCH 2021 MARCH 2022 APRIL 2022
Passing
Name of the Block

Name of the District MANGALGIRI MANGALGIRI_ MARCH 2023|

GuNIUR TENALI
Name of the State GunTUR GUNIUR
I certity IANDHRA PRADESHANDHRA PRADESH
that the school(s) in which my ward
studied/studying is a recognized
AND HRA PRAOESH
understand that even school and fulfils all the
the candidate has studied in eligibilitycriteria as per NVS
if
urban area for even a
candidate. n is also certified that my ward is in amy of the requirements.
V also
I
classes ll,
the bonafide resident and single day &V, the student will be treated as
that the above information residing with me in the same District urban
correct and submitted where he/she is
is
applying for INVST
f voluntarily certity
I
any of the information provided is found to be
wrong. the candidature of my ward will be
that no change in aforesaid data shall be forfeited at any stage even after
requested by me in future and I agee that in admission in INv. atso submit
case of mismatch in the
t
THROUGH ONLINE mode shall be trested as final onine and offline data, the
data submitted

Signature of the candidate

Signature of the Parent

Daiyaa20a A sUNILKUMAR)
Note:

The above
In respect
of rea will be decided on the basis of residence of the candidate.
detalandidate erified from school records and found correct.

TENA: KSs
Signature Seal
qHedastpa with
Viveka Primary Sehool
Nazerpet,Teis