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Child 4. Name of the Institution/College 5. Percentage of marks obtained in class XII exam/previous year/ last two semesters(as applicable) 6. Address for correspondence Place : Date (Signature of Applicant) : PART-II CERTIFICATE FROM THE HEAD OF INSTITUTION/COLLEGE 7. Certified that :(a) Mr/Ms is attending son/daughter of course year/semester in the (Name of the institute/college) (b) (c) His/Her date of admission is He/She has passed in the last semester/class(for subsequent y.

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