G0VERNMENT OF KERALA

DIRECTORATE OF GENERAL EDUCATION (HIGHER SECONDARY WING)

APPLICATION FOR ADMISSION TO THE HIGHER SECONDARY COURSE (2O24-2O25)
APPLICATION NO: 2411146830

Name: MOHAMMED NAWAF P Guardian Name: SHEREEF P

Mother's Name: SALEENA Father's Name: SHEREEF P

Date of Birth: 19-09-2007 Sex: Male

Aadhaar No: 919XXXXXX181 Enrolement No: -

Board Passed: Yes Scheme: SSLC (2023-2024) Register Number: 353485

Month of Pass: 3 Year of Pass: 2024

Category Name: Muslim OEC: No

Caste: MAPPILA Religion: Islam

Resident State: Kerala Resident Local Body: Thalakkadu

Resident District: Malappuram Resident Taluk: Thirur

Permanent Address: PAMPARAMBIL POILISSERI PO, 676102, Communication Address : PAMPARAMBIL POILISSERI PO, 676102,

MALAPPURAM MALAPPURAM

Blind: No Deaf No OH: No

IEDC : - MR/Brain Diseases: No Health Club: No

Linguistic Minority: No Minority Language: Jawan Killed In Action: No

Jawan Priority: No NCC or Scout / Guide(Puraskars) No Scout / Guide Participation : No

NTSE Qualified: No NMMSSE Qualified: No USSE Qualified: No

LSSE Qualified: No Student Police Cadet: No Red Cross: No

Forestry Club: No Environment/Nature Club: No IT Club: No

Maths Club: No Debating Club: No Philatery Club: No

Oratory Club: No Science Club: Yes Social Science Club: No

Grace Mark Awarded: No Little KITES Members With A Grade: No

SPORTS AND YOUTH FEST SL-I D-I / A D-II / B D-III / C DLP STATE FAIRS A-Grade B-Grade C-Grade D-Grade E-Grade

Sports Fest 0 0 0 0 0 State Science Fair 0 0 0 0 0

Youth Fest 0 0 0 0 0 State Social Science Fair 0 0 0 0 0

E-Mail ID: - State Maths Fair 0 0 0 0 0

Phone Number: 9995646677 State IT Fair 0 0 0 0 0

Chance Number: 1 State Work Experience Fair 0 0 0 0 0

SSLC School: 11221 Kunhimon Haji Memorial Higher Secondary School, Alathiyur

State Level First(SL-I), District First or A-Grade(D-I / A), District Second or B-Grade(D-II / B), District Third or C-Grade (D-III / C), District Level Participation(DLP)

CANDIDATE GRADE DETAILS

PAPER NAME MARK GRADE GRADE POINT

First Language- I NA A+ 9

First Language- II NA A+ 9

English NA A+ 9

Hindi NA A 8

Social Science NA A 8

Physics NA A+ 9

Chemistry NA A+ 9

Biology NA A+ 9

Mathematics NA A 8

Information Technology NA A+ 9

IT Services : NIC Kerala Page 1 / 2 IP : 103.42.196.104 - Date & Time : 31/05/2024 01:38:11 PM
 CANDIDATE OPTION DETAILS (MAIN)

Pref School Code Course Pref School Code Course Pref School Code Course Pref School Code Course

No. Code No. Code No. Code No. Code

1 11005 1 5 11221 9 9 11004 1 13 11034 1

2 11044 1 6 11062 1 10 11004 5 14 11034 5

3 11044 5 7 11062 5 11 11221 39 15 11135 1

4 11221 1 8 11011 1 12 11005 38 16 11135 39

CLAIMED CERTIFICATE DETAILS

CERTIFICATE NAME CERTIFICATE NO CERTIFICATE DATE ISSUING AUTHORITY

Science Club 40035/2024 18-05-2024 KHMHSS ALATHIYUR

.......................................................................................................................................................................................................
DECLARATION
I SHEREEF P, Parent of Master/Kumari MOHAMMED NAWAF P do hereby declare that all the information furnished in the
application are true to the best of my belief. I know that the allotment got by any false information furnished in the application will
results in the cancellation of Allotment and Admission.

Name and Signature of Parent/Guardian

Place :
Date : 31-05-2024

IT Services : NIC Kerala Page 2 / 2 IP : 103.42.196.104 - Date & Time : 31/05/2024 01:38:11 PM