Transfer Certificate sample

Transfer Certificate/School Leaving Certificate

Affiliation No. ……………………………………………. School Code…………………………………

Book No. ……………………. SI. No. …………… Admission No.……………………………..

1. Name of Pupil………………………………………………………………………………………………………………………………………………………...

2. Mother's Name………………………………………………………………………………………………………………………………………………………

3. Fathers/Guardian's Name………………………………………………………………………………………………………………………………………

4. Date of birth (in Christian Era) according to Admission & Withdrawal Register (in figures) ……………………………………

(in words)……………………………………………………………………………………………………………………………………………………………….

5. Nationality……………………………………………………………………………………………………………………………………………………………..

6. Whether the candidate belongs to Schedule Caste or Schedule Tribe or OBC………………………………………………………..

7. Date of first admission in the School with class………………………………………………………………………………………………………

8. Class in which the pupil last studied (in figures) ……………………… (in words)…………………………………………………………….

9. School/Board Annual examination last taken with result……………………………………………………………………………………….

10. Whether failed, if so once/twice in the same class…………………………………………………………………………………………………

11. Subjects Studied: 1 …………………… 2 …………………… 3 …………………… 4 …………………… 5 …………………….. 6 …………………

12. Whether qualified for promotion to the higher class……………………………………………………………………………………………..

If so, to which class (in fig.)………………………………………… (in words) …………………………………………………………………………

13. Month upto which the pupil has paid school dues…………………………………………………………………………………………………

14. Any fee concession availed of. if so, the nature of such concession……………………………………………………………………….

15. Total No. of Working Days in the Academic Session ……………………………………………………………………………………………….

16. Total No. of Working Days Pupil present in the Academic Session …………………………………………………………………………

17. Whether NCC Cadet/Boy Scout/Girl Guide (details may be given) …………………………………………………………………………

18. Games played or extra-curricular activities in which the pupil usually took part (Mention Achievement Level Therein) …………………………………………………………………………………………………………………………………………………………………

19. General conduct …………………………………………………………………………………………………………………………………………………….

20. Date of application for certificate ……………………………………………..…………………………………………………………………………..

21. Date of issue of certificate ……………………………………………………………………………………………………………………………………..

22. Reasons for leaving the school ……………………………………………………………………………………………………………………………….

23. Any other remarks ……………………………………………………..………………………………………………………………………………………….

Signature of class teacher Checked by Signature of Principal with date

(with full name and designation) School SEAL