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Government Primary/Middle/ High/ Senior Secondary School: School Leaving Certificate (Academic Year: - )

This document is a school leaving certificate for a student who attended a primary/middle/high/senior secondary school. It provides the student's name, registration number, date of birth, class attended, and date of withdrawal from the school. It also indicates whether the student passed or failed examinations and was allowed promotion or needed to join a different school. Attendance records for the school year are included. For scholarship holders, it lists the type and value of any scholarship received. School officials certify the information is correct according to school records.

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Mohit
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2K views2 pages

Government Primary/Middle/ High/ Senior Secondary School: School Leaving Certificate (Academic Year: - )

This document is a school leaving certificate for a student who attended a primary/middle/high/senior secondary school. It provides the student's name, registration number, date of birth, class attended, and date of withdrawal from the school. It also indicates whether the student passed or failed examinations and was allowed promotion or needed to join a different school. Attendance records for the school year are included. For scholarship holders, it lists the type and value of any scholarship received. School officials certify the information is correct according to school records.

Uploaded by

Mohit
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
  • Personal and School Information: Contains essential details of the student, academic year, and administrative information for school leaving.
  • Scholarship and Office Use: Details scholarship-related information and additional school administrative notes for office processing.

Annexure A2

Government Primary/Middle/ High/ Senior Secondary School


School Name , UDISE Code , Deptt. School Code

SCHOOL LEAVING CERTIFICATE

(Academic Year: — )
File No. Date of issue•

Pupil's Name
Student Registration No. (SRN) o. in Admission Register

Name of Father/Guardian Mother


Date of birth

Certified that attended this school up-to L He/she


has paid all sums due to the school, and was allowed on the above date to withdraw his/her name.
He/she was reading in Class in this school.

1. He/she was examined in and

III a. Was allowed/promised promotion to Class , OR

MI b. Passed the examination in the highest class available in the school, OR

NI c. Left the school mid-session to join a different school, OR

- d. Failed in subject(s)

Note: (please tick and fill whichever is applicable):

The following particulars are certified to be correct according to the registers of the school and the
certificate's produced from previous school/s attended during the school year:
No School Date of Date of Date of No. of total Pupil's Leaves
admission withdrawal attendance attendances attendance taken
during the during the current during the during the
current school- school year current school current
year year school year
From To
1
2
3
4

Date of issue• Signatures and seal of Head of Institution


For Scholarship-Holders Only

Kind of scholarship Value Year of award

Date up-to which drawn By whom payable

Note: Entries checked and found correct:

Signatures and seal of Head of Institution

For office use only:

Certified that S/o-D/o- ward of


and a student of the class who left the
School (School Code District with Transfer Certificate No.
Dated has joined the class
Of School (school code ),
District on
His/her date of birth mentioned in the Transfer Certificate is

Signatures and seal of Head of Institution

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