n across it. Please retain with you sufficient copies of same photograph for subsequent use. Eams Passed !ame of the "nstitution # $ni%ersity &ub'ect &tudied (onth) *ear of Passing + of (ar,s Class # Grade -egular# .istance Edu.# Pri%ate study 1/ th &td C"&CE EC0!0("C& 1 # 2//1 33 4irst -egular 12 th &td C"&CE C0((E-CE 1 # 2//1 55 &econd -egular Graduation C67C$886 $!"9E-&"8* Graduation in 6rts#Commerce 5 # 2//3 53 &econd -egular Post Graduation # 0thers # DECLARATION1 I &ere(y .e'lare t&at t&e -art%'ular/g%Ce a(oCe are true 'om-lete a. 'orre't0 I u.er/ta. t&at %# ay o# t&e -art%'ular/ are #ou. to (e #al/e3ot 'orre't3m%/re-re/ete. o a later .ate) my 'a.%.ature %/ l%a(le to (e 'a'ele. at ay t%me0 I &aCe rea. a. u.er/too. t&e /t%-ulat%o/ % t&e a.Cert%/emet a. &ere(y u.ertake to a(%.e (y t&em0
Si2nat+re o3 t'e candidate Na,e 1
Place 1 Date 1 NOTE1 T&%/ /y/tem geerate. -r%t out o# t&e a--l%'at%o /&oul. (e /%ge. (y t&e 'a.%.ate a. /et alog >%t&6 10 T&e a--l%'at%o #ee % t&e #orm o# "ema. "ra#t0 A 'a.%.ate mu/t >r%te &%/3 &er #ull ame) -o/t a--l%e. #or) /y/tem geerate. reg%/trat%o um(er o t&e reCer/e o# t&e .ema. .ra#t0 20 Co-%e/ o# 'ert%#%'ate/ -erta%%g to age) e.u'at%oal Dual%#%'at%o/0 30 Co-%e/ o# Ca/te3 Tr%(e 'ert%#%'ate/ #or SC3 ST 'a.%.ate/ oly0 !0 :&otogra-& -a/te. % t&e g%Ce -la'e a. /%ge. a'ro//0 T&e 'a.%.ate mu/t reta% t&e -&oto'o-y o# t&e /et -r%t out o# t&e a--l%'at%o #orm #or #urt&er re#ere'e0 Please retain our Registration No! and Pass"ord carefull for furt#er reference$generation of call letter!