Aishwarya Educational and Charitable Trust (R)
A EDUCA
TIO
ARY
NAL
HW
AND
AIS
CHARITABLE TRUST
Aishwarya International Public School
MADDUR
(Affiliated to CBSE, Delhi. Affiliation No. 830521)
AIS
HW
ARYA
LIC
INTER
NATIONAL PUB
SC
PASSPORT SIZE
PHOTOGRAPH
Bangalore - Mysore Road, Near H.K.V. Nagar, Maddur - 571 428.
Phone : 08232-213499 Mob : 9342524466
Email : [email protected] Web : www.aipsmaddur.com
OL
HO
APPLICATION
FORM
Student Admission No.:
APPLICATION No. :
Admission Date :
Admission Sought for Class :
1. NAME OF THE APPLICANT :
(in Block letters)
2. Father's/Guardian's Name (Relationship) :
(in Block letters)
3. Date of Birth :
Age:
4. Sex :
Years
Male
Female
STUDENT INFORMATION
1. First Name :
2. Middle Name :
3. Last Name :
4. Place of Birth :
5. Mother Tongue :
6. Nationality :
Religion :
Caste :
7. Correspondence Address :
PIN
(Please do mention the PIN code)
8. Permanent Address :
PIN
(Please do mention the PIN code)
9. Communication Numbers :
(R)
(O)
(M)
Email
FAMILY INFORMATION
1.
Name of the Father :
2.
Name of the Mother :
3.
Occupation of the Father :
Qualification :
4.
Occupation of the Mother :
Qualification :
5.
Annual Income of the Father / Mother :
6.
No. of Siblings :
Name
Age
Class
School
P.T.O.
ACADEMIC INFORMATION
1.
Class Currently Studying in :
2.
Class Seeking Admission to :
3.
Name of the Previous School Attended :
4.
Medium of Instruction :
5.
Syllabus Followed :
1st Language Opted (previous Year) :
2nd Language Opted (previous Year) :
CO-CURRICULAR INFORMATION
1.
Hobbies :
2.
Interest :
3.
Sports :
4.
Participation in Inter-school / District Level /
State Level / National Level Competitions
Awards Received :
5.
HEALTH INFORMATION
Weight :
Height :
1.
Blood Group :
2.
Health Concerns if any (Vision, Hearing, Speech, Physical) :
3.
History of communicable Diseases if any (Chicken Pox, etc.) :
4.
Allergies if any :
5.
Identification Marks :
IN CASE OF ANY EMERGENCY PLEASE CONTACT
1.
Name :
2.
Address :
PIN
(Please do mention the PIN code)
(O)
(M)
(R)
Email
PARENT DECLARATION
The above information given by me is true to the best of my knowledge. If found incorrect I agree to abide by the decision
of the school regarding my ward.
Date :
Place :
Signature of the Parent
LIST OF DOCUMENTS TO BE ATTACHED
1.
2.
3.
4.
5.
6.
7.
8.
4 Passport Size photographs of the Child
Copy of the Child's Birth Certificate
Copy of the previous school's Progress Report and other Certificates
Copy of the Transfer Certificate
Medical Certificates
Caste Certificate where applicable
Income Certificate where applicable
Merit Certificate of Scholarship where applicable
FOR OFFICE USE ONLY
Admission Status :
Approved
Not Approved
Principal
Management Representative
Date :
Place :
Mode of payment (Cash / Cheque) :
FEE DETAILS
Sl. No.
Academic Year
Amount Due
Amount Paid
Cash / Cheque
Receipt No.
Date