SRI CHAITANYA JUNIOR KALASALA Section:

Narayanaguda, Hyderabad.
APPLICATION FOR ADMISSION INTO I/II YEAR INTERMEDIATE 2021-2022

Admission No: SSC, CBSE, ICSE, OTHER BOARD:

HALL TICKET NO:
Note: Aadhar card number, Community & Sub Caste will be printed in your Intermediate Pass certificate and
Transfer Certificate. So mention correctly.

❖ Aadhar Card No (UID)*

❖ Community (Caste)*
(BC-A,BC-B,BC-C,BC-D,SC,ST,OC,BC-E,MUSLIM,OTHERS)
❖ Sub Caste* Second Language-II

❖ Group*(MPC / BPC / MEC)* * (Sanskrit/Arabic/French)*

1.Board Admission No: 2. Candidate’s Name

(FOR OFFICE USE ONLY) (AS PER 10th MEMO)

3. Father’s Name 4. Mother’s Name

Hindu, Islam, Christian
5. Nationality 6. Religion
Others :
8. Father
7. Sex Male /Female Occupation
9. Mother Tongue 10. Date of Birth
11. Physically
Handicapped Yes / No 12. Place of Birth

1.
13. Moles of
Identification (MUST) 2.
14. Name of the
Institution Last Studied
15. Parent Income Rs. /- Per annum
16. PRESENT ADDRESS
Street / LAND
H. No: MARK:
AREA/ VILLAGE Mandal (MUST):
District: State :
17. PERMANENT ADDRESS

H. No: Street:
AREA/ VILLAGE: Mandal (MUST):
District: State :
18. Mobile No. of 19. Mobile No. of
Parent / Guardian Candidate
Student Left Thumb
Student Signature
Impression Black & White Photo
(Signature Put in Middle)
Don’t Cross the line

*Sub caste: for Example : Padmasali, Mala, Madiga, Goud, Lingabalija, Kurava, Kummari,……….etc,.