CHRIST NAGAR SENIOR SECONDARY SCHOOL, THIRUVALLAM, TRIVANDRUM 0 695 027

CENTRAL BOARD OF SECONDARY EDUCATION

Registration Form for Class IX - Registration Year: 2021-2022
Class X Examination: November 2022 . March 2023

Important Instructions
All entries should be made in CAPITAL LETTERS. Use dark blue/black ball point pen only.
Candidate’s name, Mother’s name, Father’s name and Date of Birth must be strictly as per the Birth
Certificate issued by the authorised Govt. Department.
Prefix such as Master, Mr, Miss, Kumari, Mrs, Smt, Shri, Dr, Col, Brig, Late, Full stops and Commas not to be used.
Give space between first name, middle name and surname. For Sex, write 1 for male and 2 for female
For category, write 1 for Scheduled caste, 2 for Scheduled tribe, 3 for Other backward classes, 4 for OEC
and 5 for General. Code nos. allotted to the subjects are as follows.
If TC is given to the school, no change in the data written on the TC is accepted.

Year of joining in the school: Adms.No: Class & Div: IX

CANDIDATE’S NAME (same as Birth Certificate. Give space between first name, middle name and surname)

MOTHER’S NAME (same as Birth Certificate)

FATHER’S NAME (same as Birth Certificate)

DATE OF BIRTH (same as Birth Certificate) SEX SINGLE CHILD ANNUAL INCOME
1. Male
YES NO
2. Female

SUBJECT NAME SUBJECT MEDIUM

CODE CODE RELIGION & COMMUNITY CATEGORY MINORITY
1. SC
YES
1. Language - I 184 2. ST
(English LAG & LIT) 3. OBC
NO
4. OEC
RESIDENTIAL ADDRESS:
2. Language - II 5. GEN

Hindi (085) Malayalam (012) French (018) ..........................................................................................................................................

3. Mathematics Standard 041 1 ..........................................................................................................................................

4. Science 086 1 Email: ............................................................................................................................

5. Social Science 087 1 Mobile No. for Digilocker: ................................................................................................

Aadhar No:
6. Information Technology 402 1

 Parents are requested to carefully fill up the details of the candidate.

 Copy of the Birth Certificate shall be attached.
 Requests for further correction after the submission of this form to the office will not be entertained.

Signature of the Student Signature of the Mother Signature of the Father