Kurudu Sonnanahalli,Virgo Nagar P.O, Bangalore-560049. Karnataka, South India, Ph: 080 – 32479906. Recent Passport Size Photograph APPLICATION FOR ADMISSION Admission for Class: 1. Name of the Student ................................................................................................................ 2. Mother’s Name ................................................................................................................ 3. Father’s Name ................................................................................................................ 4. Date of Birth ……………………………………………. Sex : ...................................................... 5. Date of Birth in words ................................................................................................................ 6. Physically challenged Yes / No …………………………………….………………………..(If ‘Yes’ give details) 7. Blood Group ……...………………..… Only Child : Yes / No ............................................... 8. Caste ……………………………………………………….…..…… ( General / OBC / SC / ST ) 9. Religion ………………………………….Nationality : ...................................................... 10. Mother Tongue ................................................................................................................ 11. Identification Mark 1 ................................................................................................................ 12. Identification Mark 2 ................................................................................................................ 13. Communication Address ................................................................................................................ ................................................................................................................ ................................................................................................................ ................................................................................................................ 14. E_Mail ID ................................................................................................................ 15. Contact Number for SMS ............................................................................................................... 16. Other Contact Numbers ................................................................................................................ 17. Permanent Address ................................................................................................................ ................................................................................................................ ................................................................................................................ Admn.No : Attachments of Xerox copies : 1. Birth Certificate Class & Sec : 2. Caste Certificate For office use only 2. Health Report 3. Marks/Report Card Date of Admn: Remarks Originals : 1. Transfer Certificate : Signature of Parent / Guardian Signature of Principal INSTRUCTIONS TO PARENTS / STUDENTS 1. Registration for admission does not ensure an admission. Admission is granted based on merit against available vacancy only. 2. An annual fee increase of 10 to 15 percent is effective to offset the increasing expenditure by way of salary, maintenance and material expenditure as it is a private self-financing institution. 3. We expect our students to be well behaved, regular and punctual in their attendance and show remarkable progress in studies in examinations / test and in the submission of all kinds of class work / home assignment. Please Sign the following declarations 1. The information given by me is accurate to the best of my knowledge and belief. 2. I promise to abide by all the rules and regulations of the school and I will keep up the Ideals of the school and conduct myself accordingly. 3. I will put in at least 95% attendance in each subject at the end of the academic year. In case, if I violate any of these conditions, I agree that the Principal will have the right to detain me from proceeding to the annual examinations conducted by the Board. The decision of the Principal will be final and binding. Note :1. Once admission is granted the school fees has to be paid on the stipulated date to the Federal Bank, K.R.Puram branch, Bangalore - 36. 2. Use capital letters in filling the names of candidate and parents in the form. 3. Fees once paid will not be refunded. 4. Produce all documents at the time of admission as listed in the attachment. 5. It is obligatory for students to abide by the school rules and regulations. 6. School can not mention the Caste or Sub Caste in the TC unless caste certificate is produced. COURSES OFFERED FOR XI & XII (tick any one) SCIENCE PCMB - PHYSICS, CHEMISTRY, MATHEMATICS, BIOLOGY, ENGLISH PCMC.Sc - PHYSICS, CHEMISTRY, MATHEMATICS, COMPUTER SCIENCE, ENGLISH COMMERCE ABEC.Sc - ACCOUNTANCY, BUSINESS STUDIES, ECONOMICS, COMPUTER SCIENCE I have read the rules and regulations of Lake Montfort School and I fully agree to abide by them. ……………………………………………… ……………………………………………. Signature of student Signature of Parent