ADMISSION FORM

Affix one
Stamp size

A. Particulars of the student:

Photo here

1. Name :_________________________________________________________________________
(Surname)

2. Sex :_______________
____/____/______

(Name)

(Fathers Name)

3. Age :_________Yrs

5. Place of Birth :______________ 6. State : ___________

________________
8.

4. Date of Birth :
7. Nationality :

Religion :__________________ 9. Caste:_____________ 10. Mother Tongue : _____________

11. Class to which admission is

sought:__________________________________________________

B. Particulars of parents:

Father

Mother

1. Name :
______________________________
______________________________
2. Profession :
______________________________
______________________________
3. Qualification:
______________________________
______________________________
4 . Home Address:
_______________________________________________________________
_______________________________________________________________
_______________________________ Phone : ________________________
5.

Office Address:

________________________________________________________________
________________________________________________________________
______________________________
________________________

Phone :

C. Particulars of Brothers / Sisters:

1.Name : _____________________ Age : _________ Sex : _______ Education : _____________
2.Name : _____________________ Age : _________ Sex : _______ Education : _____________
D. Particulars of the last class attended:
1. Name of school :
_________________________________________________________________
2. Class : _______________________________
_______________________

3. Year of passing :

4.Reason for leaving: ______________________________________________________________

I have received and read the rules and regulations. I agree to abide by them.
Date________________
Guardians

Signature of Parents /

FOR OFFICE USE ONLY

___________________________________________ is admitted to____________________class
for
the academic year ________________________. His / Her G. R. No. is____________________.
Date: _______________

PRINCIPAL