Student Image Course/Program Details Course Applied For: SecondarySenior Secondary Course Type Full SubjectTransfer of CreditPart Admission Date of Application Personal Information Gender MaleFemaleTransgender Date of Birth Name of Applicant Father's Name Mother's Name Aadhar No. E-mail id Marital Status MarriedUnmarriedDivorcedWidowed Category SCSTOBCGEN Minority Nationality Domicile UPBiharSikkimOther Religion Whether differently abled YesNo Contact Details Permanent Address Street No City State Pincode Permanent Mobile No Current Address For Communication (If any) Full Address Parent/Guardian Name Parent Occupation Parent Guardian Contact No Parent Email Address DETAILS OF LAST CLASS/EXAMINATION PASSED Class/Examination Marks Percentage(%) Name of School/Board Division percentage(%) ` subject Choosen Language Subject Vocational Subject Other subject Additional subjects(If any) Medium of Instructoin opted for HindiEnglishNepali Note .Self Attested Copies of Certificates/Marks sheets should be attached .If you are an applicant for secondary course and do not have any school leaving certificate, please attach a self certificate of literacy saying that you know how to read and write. the format of the self certificate is altached; payment Mode of payment DDONLINE Date Amount Draft.No/URT.no Name of the bank/branch DECLARATION BY CANDIDATE I hereby declare that i have carefully read the instructions and all the informations furnished by me are correct. Candidate's Signature Parent's signature Date Place Back Subjects of TOG (If applicable) TOC subjects Subjects of BOSSE Code Subjects of part admission Part admission of subjects [ Code Back FORMAT FOR SELF CERTIFICATE OF LITERACY ( to be filled in only by applicants of secondary course ) I, (Name), Applicant for Secondary Course at the BOSSE (Board of Open Schooling and Skill Education), certify that I am literate, I can read and write (Medium of Instruction).l understand that self learning is important in the open schooling system and I take the responsibility of my own studies.l am desirous of continuing my education. l am sending this application form to BOSSE for fulfilling this desire of mine.l am grateful to BOSSE for giving me this second chance, this opportunity to continue my education. Date Signature of Applicant Place Name of Applicant Countersigned by parent/Guardian's Name of parent/Guardian's Back