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5/27/23, 10:56 AM https://apply1.tndge.

org/nodal/npos-sslc-declaration-form/eyJpdiI6IlAzV3VuKzZ5MVZXMHhBTmZuMkhHbEE9PSIsInZhbHVlIjoi…

 
Department of Government Examinations Chennai-600006
S
SSLC SUPPLEMENTARY EXAMINATION June / July - 2023

Application No. : SXOS23330401017031244997


Permanent Reg.No : XM23R2485759581
Educational District : RANIPETTAI
Candidate Name : AGALYA M A
Father / Mother /
: ARUL M
Guardian Name
Gender : FEMALE
Date Of Birth : 26/01/2008
Classification : SC - Others
Disability Status : None
Candidate Type : With Permanent Reg.No.
Mobile No : 9361962455
Address : MOSUR Pin: 631004

Applied Date : 27/05/2023


Subjects Now Appearing :

Part Subject Language / Medium


PART II 003-ENGLISH ENGLISH
PART III 005-MATHS ENGLISH

DECLARATION
      I declare that the particulars given above are true, correct and complete. I further declare that I am liable for any action to
be taken against me if at any point of time the particulars given above are proved false.
Details of Enclosures:

1. Registration Slip.
2. Self Attested Copy of Mark Certificates.
3. Disabled candidates should enclose the medical certificate along with requisition letter.
4. Science practical registration slip/Certificate given by HM for having attended practical classes.

Note : Candidate should write the Exam in New Syllabus only.


Place :
Date : Signature of the Candidate

https://apply1.tndge.org/nodal/npos-sslc-declaration-form/eyJpdiI6IlAzV3VuKzZ5MVZXMHhBTmZuMkhHbEE9PSIsInZhbHVlIjoiWjB6UjYyVnBMd2due… 1/2
5/27/23, 10:56 AM https://apply1.tndge.org/nodal/npos-sslc-declaration-form/eyJpdiI6IlAzV3VuKzZ5MVZXMHhBTmZuMkhHbEE9PSIsInZhbHVlIjoi…

Department of Government Examinations Chennai-600006


SSLC SUPPLEMENTARY EXAMINATION June / July - 2023

REGISTRATION SLIP : DEPARTMENT COPY


APPLICATION NO. : SXOS23330401017031244997

Peramaent Reg.No : XM23R2485759581

CANDIDATE NAME : AGALYA M A

Disability Status : None

Candidate Type : With Permanent Reg.No.


DATE OF BIRTH : 26/01/2008
NAME OF THE SUBJECTS APPLIED :

003-ENGLISH - ENGLISH

005-MATHS - ENGLISH

Examination Fees Online Fees Total


FEES TO BE PAID (IN CASH)
125 70 195
Details of Enclosures:

1. Registration Slip.
2. Self Attested Copy of Mark Certificates.
3. Disabled candidates should enclose the medical certificate along with requisition letter.
4. Science practical registration slip/Certificate given by HM for having attended practical classes.

Note : Candidate should write the Exam in New Syllabus only.

Signature of the Candidate

Department of Government Examinations Chennai-600006


SSLC SUPPLEMENTARY EXAMINATION June / July - 2023

REGISTRATION SLIP : CANDIDATE COPY


APPLICATION NO. : SXOS23330401017031244997

Peramaent Reg.No : XM23R2485759581

CANDIDATE NAME : AGALYA M A

Disability Status : None

Candidate Type : With Permanent Reg.No.


DATE OF BIRTH : 26/01/2008
NAME OF THE SUBJECTS APPLIED :

003-ENGLISH - ENGLISH

005-MATHS - ENGLISH

Examination Fees Online Fees Total


FEES TO BE PAID (IN CASH)
125 70 195
Details of Enclosures:

1. Registration Slip.
2. Self Attested Copy of Mark Certificates.
3. Disabled candidates should enclose the medical certificate along with requisition letter.
4. Science practical registration slip/Certificate given by HM for having attended practical classes.

Note : Candidate should write the Exam in New Syllabus only.

Receiver Signature with Office Seal Signature of the Candidate

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