Form No.

Ext -23
EXTERNAL – A/B Permission Fee – Rs. 500/-
Madhyamik/ H.S. (+2)

TRIPURA BOARD OF SECONDARY EDUCATION

Form of Application for permission (Registration* & Enrolment) to appear as an
External Candidate at the Madhyamik Examination (S.E) 20........
Higher Secondary (+2 Stage) Examination, 20.........

To
The Secretary,
Tripura Board of Secondary Education
P.N. Complex, Gorkha Basti, Agartala
West Tripura

(Through the HM/AHM/TIC)

Sir,

I seek permission (Registration/ Enrolment where applicable) to appear at Pre-Board Examination for
Madhyamik Examination (S.E)/ Higher Secondary (+2 Stage) Examination, 20………. In New Syllabus.

I am giving below the particulars about me. Should any of them turn to be incomplete/ incorrect, you may
deny my permission to sit for the Examination or cancel the Examination if taken by me and take any other
step as you may deem fit.

1. Name in full:
a) In English (in block letters).........................................................................................................................
b) In Bengali Scripts (where applicable).........................................................................................................

2. a) Father’s Name (in block letters)....................................................................................................................

b)Mother’s Name (in block letters)...................................................................................................................

3. Permanent Address...........................................................................................................................................

...........................................................................................................................................................................

4. Present Address................................................................................................................................................

..........................................................................................................................................................................

5. Date of Birth (in words)....................................................................................................................................

6. Nationality........................................................................................................................................................

7. If SC/ST/RM/OBC, specify the community........................................................................................................

8. TBSE’s Registration No. ............................................................................................. of .................................

(if already registered with the Board)

9. Education Attainments:

a) Had been reading in class (in words).........................................................................................................

of ................................................................................................................................................... school

on ................................................ (date) when discontinued.

b) If appeared at any public Examination:- i) ............................................................................ Examination

ii) Year ............................................ iii) Roll No. ................................................ iv) Result ........................

......................................................... v) Board/ University ........................................................................

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10. Madhyamik Examination:

i) Language I ..........................................................

11. H.S. (+2 Stage) Examination:

i) a) Language I : .................................................................................................. b) Language II : English

ii) Elective Subjects : (i) ............................................................. (ii) ..............................................................

and (iii) ...........................................................................................................................................................

iv) ............................................................................................... (v) ...............................................................

12. In which language questions in elective subjects/ Non-language subjects will be answered : Bengali/ English
(Strike out which is not applicable).

13. If ever punished for adopting unfair means in connection with any Examination
.........................................................................................................................................................................

14. Rs. ................................................................. submitted as Permission fee, Registration fee and Enrolment
fee. (which is applicable).

Scrutinised the papers and the statement/information furnished herewith is correct to the best of my
knowledge.

Yours obediently,

Signature Signature of the applicant

Head of the School/Institution Date: ..................................
with Office seal

Date: ..................................

List of documents submitted (herewith) :

1.

2.

3.

4.