APPENDICES

APPENDIX-A
EMOTIONAL QUOTIENT INVENTORY
Read each statement and decide which one of the following five
possible responses and best describes you. Mark your choice by
encircling the number that corresponds to your answer.
1. Never
1.

2. Rarely

3. Sometimes

4. Often

My approach in overcoming difficulties is to move

step by step

5. Always

2.

I now how to deal with upsetting problems

3.

Its fairly easy for me to express feeling

4.

I try to see thing as they really are , without

fantasizing or day dreaming about them

5.

I am in touch with my emotions

6.

I feel sure of my self in most situations

7.

Its a problem controlling my anger

8.

Its difficult for me to begin new things

9.

When faced with a difficult situation, I like to

collect all information about it that I can

10.

I believe that I can stay top on tough situations

11.

Its hard for me to share my deep feelings with

12.

others
I lack self confidence

13.

Its hard for me to make adjustments in general

14.

I like to get an overview of a problem before trying

to solve it
15.

I am fairly a cheerful person

16.

I can handle stress ,without getting to nervous

17.

Its hard or me to understand the way I feel

18.

When I am angry with others ,I can tell them about

it
19.

I have had strange experiences that cannot be

explained
20

Its easy for me to make friends

21.

I have good self respect

22

Its difficult for me to change opinions about things

23

When facing a problem ,the first I do is stop and

think
24

I do not hold up well under stress

25

I dont express my intimate feelings.

26

People dont understand the way I think

27

I dont feel good about myself

28

Its easy for me to adjust to new conditions

29

When trying to solve a problem, I took at each

parents , even if I had to be some where else at this

31.

time
I am fun to be with

32

I feel that it hard for me to control my anxiety

33

When I disagree wit someone, I am unable to say so

34

I tend to fadeout and loose contact with what

possibility and then decide on the best way

30

I would stop and help a crying child find his or her

happens around me
35

I dont get along with others

36

Its hard for me to accept myself just the way I am

37

I care what happens to other people

38

I am impatient

39

I am able to change my old habits

40

I know how to keep calm in difficult situations

41.

Its hard for me to say No when I want to

42

I get carried away with my imagination and

fantasies
43

I am happy with the type of person I am

44

I have strong impulses that are hard to control

45

Its generally hard for me to make changes in my

daily life

46

In handling the situations that arise , I try to think

of as many approaches as I can

47

Its is fairly easy for me to tell people what I think

48

I tend to exaggerate

49

I am sensitive to the feeling of others

50

I have good relations with others

51.

I feel comfortable about my body

52

Its hard for me to change my ways

53

I believe in my ability to handle most upsetting

problems
54

Others think that I lack assertiveness

55

People think that I am sociable

56

I am happy with the way I look

57

Its hard for me to describe my feelings

58

I have got a bad temper

59

Its hard for me to see people suffer

60

I get anxious

61.

I avoid hurting other peoples feelings

62

Its difficult to standup for my rights

63

I dont keep in touch with friends

64

Looking at both my good and bad points, I feel good

about my self
65

I tend to explode with anger easily

66

It would be hard for me to adjust if I were forced to

leave my home

APPENDIX-B
khzt / khzfns,
tzf. J njty.
thaf
ftdkhf

tU gff bjhlahd gy

bfhLfgLsd.

gof. mjid

xbthU

thaij

bjhlJ IJ tif ilf

vfSl bfhLfgLsd. mit

1. vbghGJ iy

2. vbghGjhtJ

4. gy neuf

5. vbghGJ

3. y neuf

t vJ cf Fzeyid KGikahf ugwJ

vgij
F

Ko brJ njbjLj ilFa viz tlLf.

f

gagLjgL.

mF

tufis

MuhF kLnk

vdnt thaij gojl

vj

czUfnsh mjFa giy jaf Fl. e.

1.

bgUghyhd Niyf eh v iyikia

2. vl jdif Fiwthf fhzgLwJ

3. eh Rakahij cilatdhf Unw

4. eh eyt vW vidg cztiy

g cWahf Ugij cznw.

5. eh vgo cnsndh mj iyna vdF Vwbjd

xJbfhs Kotiy
6. eh ehdhf Ugij idJ k milnw.
7.

vdJ cl mik kW cl iy brsfakhf

csJ vd idnw

8. vdJ njhwij g eh ktilnw

9. vl cs eyit bflitfis
ghj eh eytdhfnt Ugjhf cznw
10. eh bgUghY kilatdhf Unw
11.

vdh wiu v egfsh bfhs

Ko

12. eh kwtfSF kagtdhf Unw

13. kwtfnshL vdh KGikahf xJ nghf

20 eh nkhrkhd nfhgfhudhf UUnw

21. v nfhgij MHkhf btgL Lnw

Kotiy
14 kwtfSl eYwit ngQnw
.
15. eh kwtfnshL v gHf Toat vW w
idwhf
16. eh egfSl bjhl itJ bfhtiy
17. vDila nfhgij fLgLJtJ vdF
fbga uidahF
18. eh bghWik yhjtdhf Unw
19. vlKs y mGjkhd kd czfis
vdh fLgLJtJ fod

22 lghLfis rkhgjF goggoahf Katnj

vDila mQF KiwahF.
23 X lghlhd Niyia rF nghJ,
Kojtiu mijga midJ tufis
nrff Unw.
24 uidfSF fhgjFK mjid
g KGikahf J bfhs Unw
25 xU uidia rF nghJ Kj mijg
jhdkhf ng
26 xU uidia f KaYnghJ gytfis
MuhJ mt wjij njbjLng
27 ajhf cUthF Niyia ifaht
vdh Koj gy mQFKiwfis nahng.
28 kd czfis bgUghY vdh v
btgLj Ko
29 vDila kdbtGfis eh czjtdhf

Unw
30 vDila kd czfis eh kwtfSl
gJ bfhtJ ukkhf csJ
31. vDila czfis J bfhSj vdF
fodkhd brayhF
32 vDila cshj czfis vdh
btgLj Koaiy.
33 vdJ kd czfis vdh tf
atiy
34 adtiw bjhlFtJ vdF ukkhf
UwJ
35 bghJthf kwtUl mDrJ nghFj vgJ
vdF ukkhd brayhF
36 xiw ga vdJ muhafis kh
bfhtJ vdF ukkhd brayhF
37 a NiyfSF vdh vjhf bghU
nghf KowJ
38 giHa gHf tHffis vdh kh bfhs
Ko
39 mwhl thif eilKiw khwfis
bfhL tUtJ vdF ukkhd brayhF
40 vdJ tKiwfis kh bfhtJ fod

41 il L btna Uf ntoa Niy

.

Vglh mjndhL xJ nghtJ vdF ukkhf

UwJ.

42 vij fgidnahL ghfhk ajhj nehnfhL

ghf Kanw
43 tf Koahj ndhjkhd mDgtf vdF
VgoUwd.
4

eh F jid kwtf J

bfhtiy

45 vid R elF ff vdF

46 eh fgidf _Lnw

47 ifgL TW vz vdF cL

bjhlyhjjhf cznw.

48 iyFiya brw uidfis vgo

rkhgJ vgJ vdF bj
49 vdh fodkhd Niyfis flJ Knd
tu aY vw eif UwJ
50 mf gjw milahk vdh kd mGjij
rkhf Ko
51. eh kd mGj UF nghJ v iyia
rahf itJ bfhtiy
52 ftiygLtij vdh fLgLj Koaiy
53 fodkhd Niyf vgo mikahf Uf
ntL vW vdF bj
54 vts bga iyFiya br uidahf
UjhY mij wikahf vdh ifahs
Ko vd enw
55 eh vjbfLjhY ftiygLgthdf Unw
56 kwtf J nfhg Vglh mjidg
mtfl TLnt.
57 wUl fUJ ntWghL VgL bghGJ vdh
mij btgilahf Tw Koaiy
58 eh UdhY vdh iy vW ahUF
brhy Kotiy
59 eh idgij vdh vjhf kwtfl
vLJ Tw Ko
60 eh v wikfis / fUJfis iy ehL
w Fiwthdt vW w idwhf
61. vDila cikfSfhf vdh nghuhl

Kotiy
62 Kakhd ntiyahf X lF bry nto
UD mij jJ, mGJ bfhoUF xU
FHijF mj bgnwhiu fLoJ

bfhLgjF cj brnt
63 kwtfSF VjhtJ uidf Vgo
mjfhf eh ftiygLnw
64 kwtfSila czfSF eh kgng
65 kf JggLtij vdh ghJ bfhoUf
Kotiy
66 kwtf czfis gLJtij eh
jJLnw

APPENDIX-C

MULTIPLE INTELLIGENCE INVENTORY

Read each statement and decide which one of the following five
possible responses and best describes you. Mark your choice by
encircling the number that corresponds to your answer.
1. Never

2. Rarely

3. Sometimes

4. Often

5. Always

1.1

I enjoy telling stories and jokes

1 2 3 4 5

1.2

I have a good memory for trivia

1 2 3 4 5

1.3

I enjoy word games such as scrabble and other

puzzles

1 2 3 4 5

1.4

I read books just for fun

1 2 3 4 5

1.5

I am a good speller

1 2 3 4 5

1.6

In an argument I tend to use put downs or

sarcasm

1 2 3 4 5

1.7

I like talking and writing about my ideas

1 2 3 4 5

1.8

If I have to memorize something, I create a rhyme or

1 2 3 4 5
saying to help me remember.

1.9

If something breaks and wont work, I read the

instruction book.

1 2 3 4 5

1.10

For a group presentation I prefer to do the writing

and library research.

1 2 3 4 5

2.1

I really enjoy maths class

1 2 3 4 5

2.2

I like logical maths puzzles or brainteasers.

1 2 3 4 5

2.3

I find solving maths problems to be fun.

1 2 3 4 5

2.4

If I have to memorize something, I tend to place

events in a logical order.

1 2 3 4 5

2.5

I like to find out how things work

1 2 3 4 5

2.6

I enjoy computer and maths games

1 2 3 4 5

2.7

I love playing chess, checkers, or Monopoly.

1 2 3 4 5

2.8

In an argument, I try to find a fair and logical

solution.

1 2 3 4 5

2.9

I f something breaks and wont work, I look at the

pieces and try to figure out how it words.

1 2 3 4 5

2.10

For a group presentation I prefer to create the

charts and graphs.

1 2 3 4 5

3.1

I prefer a map to written directions

1 2 3 4 5

3.2

I daydream a lot.

1 2 3 4 5

3.3

I enjoy hobbies such as photography.

1 2 3 4 5

3.4

I like to draw and create pictures.

1 2 3 4 5

3.5

If I have to memorize something, I draw a diagram

to help me remember.

1 2 3 4 5

3.6

I like to doodle on a paper whenever I can.

1 2 3 4 5

3.7

In an magazine, I prefer looking at the pictures to

reading the text.

1 2 3 4 5

3.8

In an argument I try to keep my distance, keep

silent ,or try to visualize some solution.

1 2 3 4 5

3.9

If something breaks and wont work, I study the

diagram of how it works.

1 2 3 4 5

3.10

For a group presentation I prefer to draw all the

pictures.

1 2 3 4 5

4.1

My favorite class is gym since I like sports.

1 2 3 4 5

4.2

I enjoy activities such as wood working, sewing or

building models.

1 2 3 4 5

4.3

When I look at things, I like to touch them.

1 2 3 4 5

4.4

I have trouble sitting still for any length of time.

1 2 3 4 5

4.5

I use a lot of body movements when I am talking.

1 2 3 4 5

4.6

If I have to memorize something ,I write it out a

number of times until I know it.

1 2 3 4 5

4.7

I tend to tap my figures or play with my pencil

during class.

1 2 3 4 5

4.8

In an argument I tend to strike out and hit or run

away.

1 2 3 4 5

4.9

If something beaks and wont work, I tend to play

the pieces to try to fit them together.

1 2 3 4 5

4.10

For a group presentation I prefer to move the props

around, hold things up ,or build a model.

1 2 3 4 5

5.1

I enjoy listening to CDs and the radio.

1 2 3 4 5

5.2

I tend to hum to myself when working.

1 2 3 4 5

5.3

I like to sing.

1 2 3 4 5

5.4

I play a musical instrument quite well.

1 2 3 4 5

5.5

I like to have music playing when I am doing

homework or studying.

1 2 3 4 5

5.6

If I have to memorize something, I try to create a

rhyme about the event.

1 2 3 4 5

5.7

In an argument I tend to shout or punch or move

in some sort of rhythm.

1 2 3 4 5

5.8

I can remember the melodies of many songs.

1 2 3 4 5

5.9

I f some things breaks and wont work, I tend to

tap my fingers to a beat while I figure it out.

1 2 3 4 5

5.10

For a group presentation I prefer to put a new

words at a popular tune or music in any way
possible.

1 2 3 4 5

6.1

I get along well with others.

1 2 3 4 5

6.2

I belong to several clubs and organizations.

1 2 3 4 5

6.3

I have several very close fiends.

1 2 3 4 5

6.4

I like helping to teach each other students.

1 2 3 4 5

6.5

I like working with others in groups.

1 2 3 4 5

6.6

Friends ask my advice because I seem to be a

natural leader.

1 2 3 4 5

6.7

If I have to memorize something, I ask someone

else to quiz me to see if I know it.

1 2 3 4 5

6.8

In an argument I tend to ask a friend or some

person in authority for help.

1 2 3 4 5

6.9

If something breaks and wont work ,I try to find

someone who can help me.

1 2 3 4 5

6.10

For a group presentation I like to help organize the

groups efforts.

1 2 3 4 5

7.1

I like to work alone without else bothering me.

1 2 3 4 5

7.2

I like to keep a diary.

1 2 3 4 5

7.3

I like myself.

1 2 3 4 5

7.4

I dont like crowds.

1 2 3 4 5

7.5

I know what I am good at what I am weak at.

1 2 3 4 5

7.6

I am strong willed, independent. and I dont

usually follow the crowd.

1 2 3 4 5

7.7

If I have to memorize something, I tend to close my

eyes and feel the situation.

1 2 3 4 5

7.8

In an argument I will usually walk away until I can

calm down.

1 2 3 4 5

7.9

If something breaks and wont work, I wonder if its

worth fixing.

1 2 3 4 5

7.10

For a group presentation I like to contribute

something that is uniquely mine often based on
how I feel.

1 2 3 4 5

8.1

I am keenly aware of my surrounding and of what

goes on around me.

1 2 3 4 5

8.2

I love to walk in the woods and look at the trees and

1 2 3 4 5
flowers.

8.3

I enjoy gathering.

1 2 3 4 5

8.4

I like to collect tings such as rocks, sports, cards, or

1 2 3 4 5
stamps.

8.5

As an adult, I would like to live away from the city

where I could enjoy nature.

1 2 3 4 5

8.6

If I have to memorize something, I tend to organize

it into categories.

1 2 3 4 5

8.7

I enjoy learning the names of living things in our

environments, such as flowers and trees.

1 2 3 4 5

8.8

In an argument I tend to compare my opponent to

someone or something I have read or heard about
and react accordingly.

1 2 3 4 5

8.9

If something breaks down, I look around me to try

a see what I can find to fix the problem.

1 2 3 4 5

8.10

For a group presentation I prefer to organize and

classify the information into categories so it makes
sense.

1 2 3 4 5

APPENDIX-D
khzt / khzfns,
tzf.
J njty.

tU

gff

bjhlahd

gy

thaf bfhLfgLsd.

xbthU thaij ftdkhf

gof.

IJ

mjid

bjhlJ

tif

ilf

vfSl

bfhLfgLsd. mit
1. vbghGJ iy
4. gy neuf

2. vbghGjhtJ

3. y neuf

5. vbghGJ

t vJ cf Fzeyid KGikahf ugwJ vgij

Ko brJ njbjLj ilFa viz tlLf. F f
mF tufis MuhF kLnk gagLjgL. vdnt thaij
gojl vj f czUfnsh mjFa giy jaf
Fl. e.

1.1

fij kW eifRit JQFfis TWt

k milnw

2 3 4 5

1.2

W rgtfis eh eF id
itUng

2 3 4 5

1.3

thij isahLf, fis j

nghwtiw isahLt eh k
milnw

2 3 4 5

1.4

bghGJ nghfhfnt eh jff gonw

2 3 4 5

1.5

bgUghyhd rkaf brhfis eh rahf

iH vGJnt

2 3 4 5

1.6

wUl ngR nghJ mtfis l bra Ka

brnt

2 3 4 5

1.7

v fUJfis g ngrnth vGjnth eh

Unw

2 3 4 5

1.8

vijnaD eh kdghl bra nelh mij

id itf mjF bjhlila ghl myJ
brhbwhliu mikJ bfhnt

2 3 4 5

1.9

VnjD fU ntiy brahk gGJglh

mjDila Mnyhrid F jfij
(Instruction Book) goJ ghng

2 3 4 5

FGthf fLiu rkf ntoU

yfUJ jft nrfJ vGJtij
Unw

2 3 4 5

2.1

eh fj tFig f Unt

2 3 4 5

2.2

jf fzF (Puzzles) kW _isF ntiy

gf bra eh MirgLnw

2 3 4 5

2.3

fzF fis gJ xU ntoifahd bra

vd eh idnw

2 3 4 5

2.4

vijnaD kdghl bra ntoU

rgtfis tirgL id bfhnt

2 3 4 5

2.5

bghUf vthW aFwd vgij fla

eh Unw

2 3 4 5

2.6

f (Computer games) isahL, fj

nghwitfis brt eh kailnt.

2 3 4 5

2.7

rJuf (Chess) isahl UggLnw

2 3 4 5

2.8

thj nghJ ahakhd, fhuznjhL

fhz Ka brnt

2 3 4 5

2.9

VnjD fU gGjilJ, ntiy brahlh,

mij eF ftJ, mJ vthW aFwJ
vgij ma Ka brnt

2 3 4 5

FGthf nrJ fLiu rkF nghJ njitahd

sfglf(Charts) kW tiuglfis (Graphs)
ehnd jahf Unt.

2 3 4 5

3.1

vGjgl irFpLfSF gyhf gl sf

Ugij eh Unw

2 3 4 5

3.2

eh iwa gffd fhng

2 3 4 5

1.10

2.10

3.3

ifgl fiy (Photography) nghw bghGJnghF

ntiyf eh Mt bfhL cns.

2 3 4 5

3.4

glfis tiuJ cUthFt vdF Ug

cL.

2 3 4 5

3.5

eh vjidnaD kdghl bra nto Ujh,

mjid id itJ bfhs gl sf
mikJ bfhnt.

2 3 4 5

3.6

neu ilF nghJ jh idjgo Wf eh

Unt.

2 3 4 5

3.7

thu giff vGUgij gogij l,

m cs glfis ghfnt UggLnt.

2 3 4 5

3.8

thjhLnghJ ukhf gF bfhshk

yUfnth, bksdkhf Ufnth myJ
muidF fhz kdjs Ka
brnt

2 3 4 5

3.9

VnjD au gGJglh mJ ntiy br

jid fhL glid M brnt

2 3 4 5

3.10

FGthf izJ fLiu rkF nghJ

mjFa midJ glfis ehnd tiua
Unt

2 3 4 5

4.1

eh isahLfis Utjh clg

tF vdF f UgkhdJ.

2 3 4 5

4.2

jR ntiy, ija, khfis cUthFj nghw

brafis brt eh k milnw

2 3 4 5

4.3

eh bghUfis ghF nghJ, mij bjhl

Unt

2 3 4 5

4.4

mikahf l neu cfhUgJ vdF

fodkhd fha

2 3 4 5

4.5

ngR nghJ mf ms cl mirfis brnt

2 3 4 5

4.6

eh vijahtJ kdghl bra ntoU,

mjid mJ bfhS tiu gyKiw vG
ghng.

2 3 4 5

tF neu vdJ ufis bfhL rj

brtJ myJ vGJnfhyh jLtJ
nghwitfis bra Ka brnt

2 3 4 5

4.8

thj br nghJ bt bgwnth myJ mj

lij L Xolnth brnt

2 3 4 5

4.9

VnjD cilJ nghdhnyh ntiy brahk

nghdhnyh mj ghffis bfhL L xW
nrJ isahLnt.

2 3 4 5

FG Kaahf, xiw brJ fhL nghJ

mjFa bghUfis nrffnth, khfis
cUthfnth eh Unt.

2 3 4 5

5.1

thbdh, FWjfL (CD) nghwitfis nff

agLnt

2 3 4 5

5.2

ntiy br nghJ a irbkLfis ghl

Ka brnt

2 3 4 5

5.3

eh ghLtij Unw

2 3 4 5

5.4

xU irfUia vdh f wghf irf

Ko

2 3 4 5

5.5

eh L ntiy (Homework) br nghnjh, goF

nghnjh ir nfL bfhnl bra UggLnt

2 3 4 5

5.6

vijnaD kdghl br nghJ, mj rgt

bjhlghd ghliy cUth bfhnt

2 3 4 5

thj nghJ, eh rjkhf ngrnth, Fjnth

myJ VnjD xU ir bkoid cUth
bfhnt

2 3 4 5

gy ghlf bkLfis eh id itJ

2 3 4 5

4.7

4.10

5.7

5.8

bfhs Ko
5.9

VnjD cilJ nghdhnyh, ntiy brahJ

nghdhnyh, v ufis jo irJ bfhnl
mijg nahng.

2 3 4 5

FG Ka VnjD brJ fhL nghJ, a

thijfis fbgw ir bknlhL
bjhlgLnah myJ ntW VnjD tif
iria gagLnah btgLJnt.

2 3 4 5

6.1

eh wUl eKiw xJnghnt

2 3 4 5

6.2

eh gy rffY, kdkkwfY
nrJns.

2 3 4 5

6.3

vdF f beUa egf gy cL

2 3 4 5

6.4

kw khztfSF ghl brhju

UggLnt

2 3 4 5

6.5

kwtfSl FGthf nrJ ntiy bra eh

Unt

2 3 4 5

6.6

eh aghfnt jiytdhf njhWtjh

egf vDila Mnyhridia nfg

2 3 4 5

6.7

eh VnjD kdghl bra ntoU ntW

ahiuahtJ mJ vdF bjwjh vW nrhJ
ghf brh nfng.

2 3 4 5

VnjD thj Vglh, eh egfisnah

myJ m mf mDgt thjtiunah
Mnyhrid nfng.

2 3 4 5

VnjD cilJ nghdhnyh, myJ gGjiljhnyh

mJ g bjj ntW ahlkhtJ mij r bra
cj nfng.

2 3 4 5

6.10

FG Ka xiw btgLJ nghJ, FG

KaF eh cjahf Ung

2 3 4 5

7.1

w bjhiy eh jahfnt xU braiy

2 3 4 5

5.10

6.8

6.9

bra Unt.
7.2

eh ehF (Diary) vGj Unt

2 3 4 5

7.3

bgUghY vid vdF oF

2 3 4 5

7.4

Tlij flh vdF ofhJ

2 3 4 5

7.5

eh v wjt, v Fiwilat vgij

mnt

2 3 4 5

7.6

eh f kdcW giljt, Rjukhdt

nkY xU Tl bgUghY bry
khnl.

2 3 4 5

eh vijahtJ kdghl bra ntoU,

fiz _obfhL mj Niyia g
ng

2 3 4 5

thj VgL nghJ bgUghY mj lij

L y brW vid mik gL
bfhnt

2 3 4 5

7.9

VnjD gGJgL ntiy brahk nghdh mij

r bra ntLkh vW nahng

2 3 4 5

7.10

FGthf nrJ xiw btgLJ nghJ, eh

mijg vd cznw vgJ wUF
bjgo, vdnf cjhd fUJfis bjf
Kang

2 3 4 5

8.1

vDila RWwij m vd fwd

vgjid eh f mfiwl mJns.

2 3 4 5

8.2

fhoD elJ brW kufis, fis

fL uf eh Unw

2 3 4 5

8.3

eh njhl ntiy brt kWnw.

2 3 4 5

8.4

jghjiyf, isahL milf kW ghiw

khfis nrff eh Unw

2 3 4 5

8.5

eh bgat Md wF, efwij L btna

aifia mDgF l tf

2 3 4 5

7.7

7.8

Unw
8.6

8.7

8.8

8.9

8.10

vijnaD kdghl br nghJ, mjid

gFgFahf J xGFgL bfhs Ka
brnt

2 3 4 5

eh thG Niy tsU cdf

(f, kuf nghwit) bgafis mJ
bfht k milnw.

2 3 4 5

xU thj vDl thgtnuhL eh

Vfdnt mj myJ goj xU fl
xL ngr Ka brnt

2 3 4 5

VnjD au gGjiljh, mj uidia

f VnjD t csjh vW RWKW
ghng

2 3 4 5

FG Ka xiw mf KgLnghJ, mj
brfis KiwgL, bghUgLgo mikJ
bfhs Ka brnt.

2 3 4 5

APPENDIX E

PERSONAL INFORMATION BLANK

1. Name of the Student

2. Name of the school and Address

3. Date of Birth

4. Sex

: Male/Female

5. Group of study in +2

: Maths / Science / Arts /

Vocational
6. Educational Qualification of Father

: 1-5 / 6-10 / HSc / Degree /

PG Degree /Diploma /

Illiterate

7. Educational Qualification of Mother

: 1-5 / 6-10 / HSc / Degree /

PG Degree / Diploma / Illiterate

8. Religion

: Hindu/Muslim/Christian

9. Community

: OC / BC / MBC / DNC / SC / ST

10.Family Members

S.No

Relationship

1.

Father

2.

Mother

Name

Monthly

Job

Income

1.
3.

Brothers

2.
3.
1.

4.

2.

Sisters

3.

11. Encircle your of birth order

1/ 2/3/4/5

12.
Marks obtained in

Marks obtained in SSLC (X th)

Matriculation (X th)

Examination
S.No
1.
2.
3.
4.
5.

Subject
Tamil

Examination
Marks
/ 100

English
Mathematics
Science
Social Science
Total

/ 100
/ 100
/ 100
/ 100
/ 500

Subject
Tamil

Marks
/ 200

English
Mathematics
Science
Social Science
Total

/ 200
/ 200
/ 300
/ 200
/ 1100