Admission Form for Session 2016-2017

       
Basic Details
Name of the student * :  
Admission for class *: Stream For (+2) * :
Gender: Date of Birth *:  
Age on 1st April 2015 *:       Belongs to :
Nationality * : Religion * :
Languages Known : Others (if any) :
2nd Language : Facilities to be availed :
Mode of conveyance (in case of day scholar) :
Whether he/she is only child :  Brothers :  Sister : Adhar Card No :
EDUCATIONAL BACKGROUND Details
Name of the School last attend Address of the School Last Exam appeared Medium and Board of Instruction % of marks in pre-board Exam (+2)
Parent Details
  Father’s Mother’s Local Guardian(For Boarders Only)
Name
Surname
Date of birth
Nationality
Religion
Qualification
Occupation
Designation
Name of Organisation
Off./Business Address
Post Office
District
Pin Code No.
Permanent Address
Post Office
District
Pin Code No.
Phone No. (S)
Mobile No. (S)
Attach the Following
1 Photocopy of birth certificate
3 coloured stamp sized photographs of student Photo 1
Photo 2
Photo 3
1 photocopy of the last year’s / current year’s report card
1 photocopy of Parents/Guardians income certificate.
Cast Certificate (in case of SC/ST/OBC).
1 photocopy of ration card.
1 photocopy of Aadhar UID no. if any.
1 photocopy of single girl child’s affidavit.
Payment receipt copy (RTGS/NEFT/OTHER)

INSTRUCTION

Please Submit the following along with the form : a) 1 photocopy of birth certificate. b) 3 coloured stamp sized photographs of student. c) 1 photocopy of the last year’s / current year’s report card. d) 1 photocopy of Parents/Guardians income certificate. e) Cast Certificate (in case of SC/ST/OBC). f) 1 photocopy of ration card. g) 1 photocopy of Aadhar UID no. if any. h) 1 photocopy of single girl child’s affidavit.

CERTIFICATE FROM PARENTS

I solemnly declare that to the best of my knowledge, the information given above is correct. I fully understand that the school on accepting the Registration form of my ward is not in any way, obliged to grant admission and registration fee is not refundable. I also agree that the decision of the Principal regarding admission will be final and binding on me. On my own accord I will withdraw the child on a letter from the school in the event of any violation of the school’s code of conduct. In this regard the decision of the Principal will be final and binding on me.

     
Date *FULL NAME OF FATHER*FULL NAME OF MOTHER*

INDEMNITY BOND

In the event of any injury or harm or loss of life during the course of the stay of my ward in the school, I shall not hold the school or authorities responsible for the same. Also, I understand that 1 month’s notice need to be given to the school in case I wish to withdraw my child.

   
Date *FULL NAME OF PARENTS/GUARDIAN *

Note:

  • Filling the forms does not ensure admission.
  • Accommodation in the School & Hostel is as per vacancy existing.
  • The form must be signed by the parent/guardian only.
  • Both parents must accompany the child at the time of the interview.
  • Hostel is provided from Class-II onwards normally.
THIS IS COMPUTER GENERATED FORM, NO SIGNATURE IS REQUIRED (PARENTS / FATHER-MOTHER / GURARDIAN). ONLY YOU FILL-UP THIS FORM THRU’ ONLINE AND ATTACH PASSPORT SIZE PHOTOGRAPH OF(Student, Father & Mother / Guardian).


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Shamayita Convent School
Good Start for your child

info@shamayitaschool.in
+91 9002224333 / 9153377955
Amarkanan, Bankura 722 133, West Bengal.
Visiter No: 25009