ASIAN PUBLIC SCHOOL, UMRA         

Hansi, Hisar (Haryana) 125033

  (C.B.S.E. Affiliation No. 531735)

Website :www.apsumra.in    Mobile : 8168675307 E-mail : apsumra@gmail.com

SCHOOL LEAVING CERTIFICTE CUM TRANSFER CERTIFICATE

Date…………………  Ref. No……………………  Admission No………..…  SRN: …………..……………

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

2. Fathers/Guardian’s Name ……………………………………………………………………………………..

3. Mother’s Name…………………………………………………………………………………………………….

4. Nationality…………………………………………………………………………………………………………..

5. Whether the candidate belongs to Schedule Caste or Schedule Tribe………………………………..

6. Date of first admission in the school with class……………………………………………………………

7. Date of birth (in Christian Era) according to Admission Register (in figures) ……………………… 

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

8. Class in which the pupil last studied (in figure) …………… (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 paid………………………………………………

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

15. Total No of working days…………………………………………………………………………………………

16. Total No. of working days present…………………………………………………………………………….

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

18. Games played orextracurricular 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 Checked by   Principal

Class Teacher (state full name and designation)       Seal