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Name of the applicant as in the SSLC book (അപേക്ഷകന്‍റെ പേര്)

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State (സംസ്ഥാനം)




Mobile number of father/mother

Examination

Year of pass  
% of marks  
No. of chances  

English  
Physics  
Chemistry  
Maths  


Examination  

Period  
Year of pass  
% of marks  
No. of chances  

English  
Physics  
Chemistry  
Maths/Biology  

Period  
Year of pass  
% of marks  
No. of chances  

English  
Economics  
Accountancy  
Statistics  

Period  
Year of pass  
% of marks  
No. of chances  

English  
Economics  
Politics  
Sociology  

Group/Trade  
Period  
Year of pass  
% of marks  
No. of chances  

English  
Physics  
Chemistry  
Maths/Biology  


Examination  

Group/Trade  
Period  
Year of pass  
% of marks  
No. of chances  


Periods of breaks if any in the studies and the reasons for the same (പഠനം മുടങ്ങിയിട്ടുണ്ടെങ്കിൽ ആയതിന്‍റെ കാലയളവും കാരണവും )


Branch applied for (according to order of preference)(അപേക്ഷിക്കുന്ന ബ്രാഞ്ച് മുൻഗണന ക്രമത്തിൽ)
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