RSEWC HIGH SCHOOL, RAYAGADA RSEWC HIGH SCHOOL, RAYAGADA

APPLICATION FOR SLC/TC/STUDY CERTIFICATE/OTHER DOCUMENTS APPLICATION FOR SLC/TC/STUDY CERTIFICATE/OTHER DOCUMENTS

1. Name of the student : ________________________________________________________ 1. Name of the student : ________________________________________________________

2. Father’s/Mother’s name : _____________________________________________________ 2. Father’s/Mother’s name : _____________________________________________________

3. Class in which he/she left the school (Mention year & class) : __________________ 3. Class in which he/she left the school (Mention year & class) : __________________

4. Whether passed AHSE (Mention year of passing with Roll No.) : _______________ 4. Whether passed AHSE (Mention year of passing with Roll No.) : _______________

5. Aadhar No. of the student : _____________________________________________________ 5. Aadhar No. of the student : _____________________________________________________

6. Address with contact No. : _____________________________________________________ 6. Address with contact No. : _____________________________________________________

7. Reason for living the school : ___________________________________________________ 7. Reason for living the school : ___________________________________________________

Clearance certificate from Clearance certificate from

1. Class Tr : ______________________________________ 1. Class Tr : ______________________________________

2. NCC I/C:________________________________________ 2. NCC I/C:________________________________________

3. Sport I/C: ______________________________________ 3. Sport I/C: ______________________________________

4. Scout/guide/JRC I/C: ________________________ 4. Scout/guide/JRC I/C: ________________________

5. Library I/C: ____________________________________ 5. Library I/C: ____________________________________

6. Hostel I/C: _____________________________________ 6. Hostel I/C: _____________________________________

7. Others If any: __________________________________ 7. Others If any: __________________________________

Signature of the student/parent Approval of the Headmaster Signature of the student/parent Approval of the Headmaster