SSLC 2020 Annexure

ANNEXURE –A THSLC EXAMINATION – MARCH 2020 Application for Private/ARC/BT Categories 1. Name of Centre and Centre No. : 2. Name of the Candidate : 3. Sex (Male or Female) : 4. Address with Phone No. : 5. Religion and Caste : 6. Whether eligible for fee concession if so category: 7. Date of birth : 8. Name of guardian 9. Medium of Instruction : 10. Chances of Appearance : 11. No. of paper not eligible for higher studies : 12. Details of the papers appearing for : Sl. No. Subject Grade secured (Private and BT) 21 13. Whether appearing for betterment : Y/N If so, name of the school first appeared : 14. Whether ARC? : Y/N If yes, whether acquired enough attendance? : 15. Details of fee remitted Fee Fine Cost of THSLC Total Date of remittance of the fees 16. Other details, if any The details given above are true. The particulars of all the previous appearances are furnished in this application Place: Date : Signature of the Candidate ANNEXURE –B THSLC EXAMINATION –MARCH 2020 Application for Scrutiny/Photocopy/Revaluation of the Answer Script 1. Register No. : 2. Name of Candidate : 3. Address with Phone No. : 4. Name of Centre and Centre No. : 5. Medium of Instruction : 6. Details of papers : Sl.No Subject Grade Secured Items applied for (put X mark) Fee remitted Scrutiny ( 50/-) Photocopy ( 200/-) Revaluation ( 400/-) 1 2 3 4 5 6 Details of previous appearances and subjects passed (Private and BT) Sl. No Year Register No Subject 22 7 8 9 10 7. Details of the fee remitted at the exam centre Receipt No Date Amount Total Scrutiny Photocopy Revaluation Place: Date: Signature of the Candidate Note : Fees should be remitted in cash to the Headmaster of the Examination Centre. ANNEXURE – C THSLC EXAMINATION- MARCH 2020 Application for cancellation of candidature 1. Centre No 2. Educational District 3. Name of Candidate : 4. Register No : 5. Name of School : 6. Reason for cancellation : 7. Documents submitted as proof : 8. Whether removed from the roll : 9. If yes, reason for the same and ; Date of removal 10. Whether participated in the : IT practical examination 23 11. Other details if any : 12. Signature of the Guardian : The above mentioned statements are true. Hence, the request to cancel the candidature is recommended. Place: Date: School Seal Signature of the Head of Institution Note:- Application should reach the office of the Secretary to the Commissioner for Government Examination on or before 28/02 /2020. ANNEXURE – D THSLC EXAMINATION –MARCH 2020 CERTIFICATE TO CSWN FOR EXAMINATION CONCESSION ISSUED BY THE HEAD OF THE SCHOOL Signature of the Candidate ……………………………………………………………………… I, hereby certify that Master/ Kumari …………………………………………………..……………… is a student of THSLC of ………………………………………………………………………… School, whose signature is given above. He/ She is having …………………….% I.Q and disability in …………………………………………(category of disability) as per the certificate issued by Medical Board/ Physician in Psychiatry from a Government Hospital. The following examination concessions are recommended for the candidate 1. 2. 3. 4. 5. 24 Place : Date : Signature Name & Designation of the Head of the institution Office Seal Place : Date : Countersigned District Educational Officer Office Seal ANNEXURE – E THSLC EXAMINATION –MARCH 2020 QUESTION PAPER STATEMENT Name of Centre : Centre Code : Phone No. : Name of Educational District …………………………..………………….……………………….. PAPER SUBJECTS No. OF QUESTION PAPERS REQUIRED REMARKS I MALAYALAM II ENGLISH III SOCIAL SCIENCE/HUMANITIES (IHRD) IV PHYSICS V CHEMISTRY VI MATHEMATICS VII MECHANICAL ENGINEERING VIII COMPUTER SCIENCE &IT IX GENERAL ENGINEERING X ELECTRICAL TECHNOLOGY II XI ENGINEERING DRAWING III XII BIOLOGY XIII TRADE THEORY (15 PAPERS SHOWN BELOW SEPARATELY) 1 FITTING 2 WELDING 3 TURNING 4 ELECTRICAL WIRING AND MAINTENANCE OF DOMESTIC 25 APPLIANCE (EW & MDA) 5 MAINTENANCE OF TWO WHEELERS & THREE WHEELERS 6 ELECTROPLATING 7 ELECTRONICS 8 SURVEYING 9 RUBBER TECHNOLOGY 10 PRINTING 11 MOTOR MECHANIC (AUTOMOBILE) 12 REFRIGERATION & AIR CONDITIONING 13 PLUMBING 14 MASONRY & CONCRETE WORK 15 AGRICULTURE XIV ELECTRONICS II (TRADE THEORY) XV IT (School Seal) SIGNATURE OF SUPERINTENDENT / PRINCIPAL 26 ANNEXURE – E THSLC EXAMINATION –MARCH 2020 QUESTION PAPER STATEMENT (Old Scheme) Name of Centre : Centre Code : Phone No. : Name of Educational District …………………………..………………….……………………….. PAPER SUBJECTS No. OF QUESTION PAPERS REQUIRED REMARKS I MALAYALAM II ENGLISH III HUMANITIES IV PHYSICS V CHEMISTRY VI MATHEMATICS VII MECHANICAL ENGINEERING VIII COMPUTER SCIENCE & IT IX ELECTRICAL ENGINEERING X ELECTRICAL TECHNOLOGY II XI ENGINEERING DRAWING XII BIOLOGY XIII TRADE THEORY (16 PAPERS SHOWN BELOW SEPARATELY) 1 FITTING 2 WELDING 3 TURNING 4 ELECTRICAL WIRING AND MAINTENANCE OF DOMESTIC APPLIANCE (EW & MDA) 5 MAINTENANCE OF TWO WHEELERS & THREE WHEELERS 6 ELECTROPLATING 7 T V MAINTENANCE & REPAIR 8 ELECTRONICS 9 SURVEYING 10 RUBBER TECHNOLOGY 11 COMPOSING, PROOF READING & BOOK BINDING 12 MOTOR MECHANIC (AUTOMOBILE) 13 REFRIGERATION & AIR CONDITIONING 14 PLUMBING 15 MASONRY & CONCRETE WORK 16 AGRICULTURE XIV ELECTRONICS II (TRADE THEORY) XV IT (School Seal) SIGNATURE OF SUPERINTENDENT / PRINCIPAL 27 Annexure C 2 CERTIFICATE OF SPECIFIC LEARNING DISORDER Signature of the Student Thumb impression I Dr…………………………………………………….hereby certify that……………………… ……………………………………………….whose date of birth is…………………………… of …………………………………….. class…………………………of…………………………. School, Son/Daughter of………………………………………………………………….whose Signature and thumb impression is given above is suffering from learning Disorder.  With impairment in reading  With impairment in written expression  With impairment in mathematics  Combined. The following supporting documents are attached (Strike whatever is not applicable)  Request of parents  Report of teachers  Report of remedial education teacher  Assessment report of clinical psychologist in the prescribed format (Annexure 2) CERTIFICATE ISSUED ONLY FOR AVAILING SSLC EXAMINATION CONCESSIONS FOR THE YEAR…….. Place: Signature of the Psychiatrist Date: Name & Designation Register Number Signature of Hospital Superintendent Office Seal

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