Book No................................. SI. No. ................................... Admission No. ..........................
1. Name of Pupil
2. Fathers/Guardian's Name .....................................................................................................................
3. Nationality...............................................................................................................................................
4. Whether the candidate belongs to Schedule Caste or Schedule Tribe.................................................
5. Date of first admission in the School with class.....................................................................................
6. Date of birth (in Christian Era) according to Admission Register
(in figures).............................................(in words)..................................................................................
7. Class in which the pupil last studied (in figures)...........................................(in words)........................
8. School/Board Annual examination last taken with result.......................................................................
9. Whether failed, if so once/twice in the same class................................................................................
10. Subjects Studied : 1.........................2..........................3.......................4.......................5......................
11. Whether qualified for promotion to the higher class...............................................................................
If so, to which class (in fig.).........................................................(in words)...........................................
12. Month upto which the (pupil has paid) school dues paid.......................................................................
13. Any fee concession availed of : if so, the nature of such concession...................................................
14. Total No. of working days........................................................................................................................
15. Total No. of working days present..........................................................................................................
16. Whether NCC Cadet/Boy Scout/Girl Guide (details may be given) .....................................................
17. Games played or extra curricular activities in which the pupil usually took part
(mention achievement level therein).......................................................................................................
18. General conduct.....................................................................................................................................
19. Date of application for certificate ..........................................................................................................
20. Date of issue of certificate ....................................................................................................................
21. Reasons for leaving the school ............................................................................................................
22. Any other remarks..................................................................................................................................
Signature of Checked by Principal
Class Teacher (state full name and designation) SEAL
* Transfer certificate should be issued only under the signatures of the regular Principal/Vice Principal
and it should be counter-signed by an officer not below the rank of District Inspector of Schools/Deputy
Director of Education/Education Officer of the Education Deptt. of the State/Union Territory concerned. In case of a student migrating from one CBSE affiliated school to another CBSE affiliated school the transfer certificate of a previous school of such a student may be countersigned by the Regional Officer of the Board or the Asstt. Commissioner of the KVS or the Deputy Director, Navodaya Vidyalaya Samiti in India or an officer of the Board at the Head Quarters and by the First Secretary/Attache/Cultural Attache or an equivalent officer of the Embassy/High Commission of India in the concerned country in respect of students studying in an affiliated school of the CBSE situated outside the country and the student shall not be admitted to a school without
such a counter signature.