| 1. |
Name of the Student (All in block letters) |
|
| 2. |
Sex |
Male
Female |
| 3. |
Date of birth |
|
| 4. |
Nationality |
|
| 5. |
State |
|
| 6. |
Religion |
|
| 7. |
Caste (for statistical purpose only) |
|
| 8. |
Community |
OC / BC / MBC / SC / ST |
| 9. |
Mother Tongue |
|
| 10. |
Residential Address |
|
| 11. |
| Parents / Guardians Information : |
| Name |
| Qualification |
| Occupation |
| Designation |
| Office Address |
| Mobile |
| Land line |
| Office Telephone No. & Fax No. |
| E-mail Address |
|
| Father |
Mother |
| ...................................... |
...................................... |
| ...................................... |
...................................... |
| ...................................... |
...................................... |
| ...................................... |
...................................... |
| ...................................... |
...................................... |
| ...................................... |
...................................... |
| ...................................... |
...................................... |
| ...................................... |
...................................... |
| ...................................... |
...................................... |
|
| |
| Guardian |
| Name |
...................................... |
Designation |
...................................... |
| Qualification |
...................................... |
Mobile |
...................................... |
| Occupation |
...................................... |
Res. Phone |
...................................... |
| Res. Address |
......................................
...................................... |
E-mail |
...................................... |
|
...................................... |
Relationship with the child |
...................................... |
|
| 12. |
Name and Class of sister(s) / brother(s)
studying in Shrishti if any
(mention CBSE / MATRIC) |
.........................................................................
.........................................................................
......................................................................... |
| 13. |
II Language preferred (Hindi / Tamil / French) |
......................................................................... |
| 14. |
Information concerning the child’s
previous
study : |
|
(a) Name and address of the school |
|
|
(b) Medium of instruction till now |
|
|
|
(c) Board Exam done
(CBSE, ICSE, MATRIC, State Board) |
|
| 15. |
Awards won in games, sports, fine arts,academics (enclose photocopies) |
|
| 16. |
Reason for changing school |
|
| 17. |
Have you applied for admission to Shrishti
earlier? If so state the year
|
|
| 18. |
For XI Admissions only : |
|
| |
Group to which admission is sought |
| First Preference |
....................... |
Group |
| Second Preference |
....................... |
Group |
|
|
| State syllabus : Groups Offered |
A Group - |
Maths, Physics, Chemistry, Biology. |
| B Group - |
Maths, Physics, Chemistry, Computer Science. |
|
| CBSE Syllabus : Groups Offered |
A Group - |
Maths, Physics, Chemistry, Biology. |
| B Group - |
Maths, Physics, Chemistry, Computer Science. |
| C Group - |
Accountancy, Business Studies, Maths & Economics |
|
|
1. I, hereby declare that all the particulars given above are true and correct and I will not ask for any change in the date of birth furnished above.
2. On admission, I agree to abide by the school rules and regulations in force and those that may be framed from time to time including the fee rules of the school. |
|
|
|
Date : ...................................... |
Signature of Parent / Guardian |
|
|
|
Note :-
1. Internet copy of the 10th Std. Public Exam Mark sheet should be submitted to the school office within a day of the publication of the results in the internet mentioning the application no. of this form and the name of the student.
2. If all columns are not filled in properly or if the following enclosures are not made, the application will be rejected.
3. The interview/entrance examinations will be held in the month of March/April. Date will be intimated later by post for classes VI to X.
4. The date of interview will be intimated while submitting the internet copy of the Std. X Public Exam marks.
5. Address for Communication:-
The Trustee
Makhija Foundation Hostels
Katpadi – Ranipet Road, Brammapuram
Vellore – 632 014. Phone : (0416) 2246784, 2246785.
E-mail Id : hostel@ shrishti.org
6. Please enclose:-
Photo copy of the latest available mark sheets of the Present School.
|
|
|
Please submit the filled form between 9.00 a.m. & 4.30 p.m. at the school office or by
post on or before ................................................. |
|
|
For office use only
Admitted in ____________________________________ Std on ______________________
Principal |