LAKSHMI NARAYANA VIDYANIKETHAN

(Affiliated to Central of Secondary Eduction, Delhi. Affiliation no.930368)
Palappuram, Ottappalam,Kerala-679103

1

Name of the Pupil

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2

Father’s/Guardian’s Name

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3

Nationality

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4

Whether the candidate belongs to Schedule Cast or Schedule Tribe or Backward Communities

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5

Religion and Community

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6

Date of Birth (In Christian era)according to admission registration in figures and words

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7

Identification Marks

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1

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2

8

Date of First admission in School with Class

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9

Class in which the pupil last studied in words & figures

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10

School/Board Annual examination last taken with result

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11

a. Whether qualified for promotion to next standard? If so, to  which class?

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b. If failed, once/twice in the same class

12

Subjects Studied

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13

Whether the pupil has paid all fees due to the school?

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14

Any fee concession availed of, if so, the nature of such concession

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15

Total No. of working days

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16

Total No. of  days present

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17

Games played or extra curricular activities in which the pupil usually took part. (Mention achievement level therein whether Regional / District / State / National level)

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18

Date of pupil’s last attendance at school

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19

General Conduct

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20

Date of application for certificate

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21

Date of issue of certificate

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22

Reason for leaving the school

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23

Any other remarks

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24

Name of the School to which admission is sought

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