Application for Withdrawal

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Date of Application

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Name of Scholar

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Name of parenf or Guardian applying and .
Relationship to Scholar

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Class, Section & Year of School leaving

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His or her father's I Guardian Name
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' Occupations
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• ·Residence

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Religion & Caste

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Date &Cause of Withdrawal

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I hereby certify that the above statement is correct .
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•Signature of Parent or Guardian

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