APPLICATION FOR BALA RATHNA/BALA SURYA ZONAL LEVEL SELECTIONS IN Telangana / Andhra / Rayalaseema Region. ************************************************************************ 01 Name of the Candidate (In full): Recent 02 Date of Birth ....:.... :D Passport Size (In words).: Photo (evidence should be produced) 03 Age as on 1st June 2008..: ______ Years ______ Months ______Days 04 Caste (SC/ST) evidence should be produced.: 05 Nationality........: 06 If He/She Physically Challenged: (Category & Percentage certificate must be produced) 07 Admission No & Year.: (Nearest Bal Bhavan / Bal Kendra) 08 Class / School address..: (with School Phone No's) 09 Applying for ..... : Creative Performance (Dance) Creative Performance (Music) Creative Art Creative Scientific innovation Creative writing 10 Name of the Father/Mother/Guardian.: 11 Residential address ....: (With land phone & mobile No's) 12 No of times attempted for Bala Rathna/Bala Surya....: 13 Other activities......: 14 No of Enclosures of (Bio-data, Photos, Press cuttings, certificate etc.,) ..: Signature of the participant ================================================================ DECLARATION BY THE PARENT/GUARDIAN This is to certify that the above particulars of my daughter/son are fact and true best of my knowledge. I will accept the norms of Bala Rathna & Bala Surya Signature of Parent/Guardian ************************************************************************ DECLARATION BY THE SUPERINTENDENT OF NEAREST BAL BHAVAN/BAL KENDRA This is to certify that the above candidate has admitted in our Bal Bhavan/ Bala Kendra and participated Zonal level competition in the Telangana /Andhra / Rayalaseema region at _______________ ____________________________on______________ and fulfilled all the norms. Signature of the Superintendent Bal Bhavan / Bal Kendra
