APPENDIX FOUR FORM OF SCHOOL LEAVING CERTIFICATE [Vide Rule 17]- SS CODE

 

APPENDIX FOUR

FORM OF SCHOOL LEAVING CERTIFICATE

[Vide Rule 17]

 

(No change in any entry in this certificate shall be made except by the authority issuing it and any infringement of this requirement is liable to involve the imposition of penalty such as that of rustication.)

 

Register No. of the Pupil:

 

Name of School:

 

1. Name of pupil in full           . .                     . .

 

2. Caste and sub-caste only in the case

of pupils belonging to backward

classes and category among back

ward classes (e.g., S.C./S.T., etc.).

 

3. Place of birth                       . .                     . .

 

4. Date of birth, month and year

According to the Christian era, both

In words and figures.

 

5. last school attended            . .                     . .

 

6. Date of admission   . .                     . .

 

7. Progress                               . .                     . .

 

8. Conduct                              . .                     . .

 

9. Date of leaving school        . .                     . .

 

10. Standard in which studying and

Since when.                                                     . .

 

11. Reason of leaving school              . .

 

12. Remarks                . .                     . .         . .

Certified that above information is in accordance with the school register.

 

Dated. . . . . . . . . . . . . . . 19  .                         Class Master.               Head of the School.

 

N.B.:1. Entries regarding the date of birth according to the Christian era and the new national calendar, and the standard in which studying in columns 4 and 10 of the leaving certificate should be made both in figures and in words.

 

2. These entries shall be in manuscript and not typewritten.

 

3. Accelerated promotion earned by the pupil during his/her school career should be specified in the Remarks column, indicating the standard, year and the school in which the accelerated promotion was given.

 

4. In the case of a pupil holding any of the following scholarships, the name of scholarship held should also be indicated in the remarks column:

1)      Middle school scholarship.

2)      High school scholarship.

3)      Vidarbha middle school stipend.

4)      Vidarbha high school stipend.

5)      Government open merit scholarship meant for bright and deserving students from rural areas-middle school/high school.

6)      National scholarship at secondary stage for talented children from rural areas in high school.

 

The prescribed index card should also be attached duly filled in respect of any of these scholarships holders.

 

(Government circular, E. and Y.S.D. No SCH. 1076/24969/XXV of 30^th September 1977).

 

(Please also see Annexure 36).