Adm Form - Ayesha Tarin Modern Public School
S.No. .............. (for office use) Ayesha Tarin Modern Public School (+2), Aligarh APPLICATION FOR REGISTRATION & ADMISSION TEST CLASS.......................... SESSION 201..... - 201..... Instructions: . (a) All the details must be filled in CAPITAL Letters. (b) Duly filled Application Form along with the following attachments be sent/submitted to the concerned section of the School Office: i. Demand Draft of ` 500/- in favour of AYESHA TARIN MODERN PUBLIC SCHOOL payable at Aligarh. ii. Duly attested photocopies of the Date of Birth and the Class Passed from the School last attended. (c) Transfer / Migration Certificate will be submitted in Original duly countersigned by the competent authority at the time of completing admission. Paste recent most Passport size photograph of the candidate 1. Name of the Candidate: ................................................................................................................................... 2. Date of Birth (in words): ................................................................................................................................. (in figures): ................................................................................................................................ 3. Place of Birth: ................................................ Religion: ......................................... Caste: ............................ 4. (a) State of Domicile: ..................................................... (b) Nationality: ...................................................... 5. Parents Particulars: (a) Father Name: Paste recent most (a) Mother Paste recent most ............................................................... Passport size ............................................................... Passport size photograph Qualification: ............................................................... photograph ............................................................... Profession of the Father ............................................................... of the Mother ............................................................... 6. Address: ............................................................... ............................................................... ............................................................... ............................................................... ............................................................... ............................................................... Tel. No. with STD ................................. Tel. No. with STD ................................. Mobile No.: ........................................... Mobile No.: ........................................... 7. Local Guardian Particulars: (a) Name: ....................................................................., (b) Relation: ............................................................ (c) Address: .................................................................................................................................................... ............................................................... Tel. No. ................................... Mobile. No. ................................... 8. (a) Class/Std. Pass ................................. (c) % of Marks: ......................................... (b) Year of Passing: ......................................... (d) Medium of Instruction: ............................. (e) School Name with Address: ...................................................................................................................... 9. Any Brother and / or Sister studying in the school? If yes, give details: (a) Name: ................................................... Class ................................................................ (a) Name: ................................................... Class ................................................................ (a) Name: ................................................... Class ................................................................ 10. (a) School Transport facility required: Yes / No (b) If yes, Name of the Bus Stop............................................................................ (Pl. refer Bus Route 11. Plan) Hostel Facility required (For Boys only fro Classes III - XII): Yes / No (a) Is your son/daughter/ward suffering from any chronic disease and taking medicine? Yes / No (b) If Yes, Please provide details with full information duly supported by documentary evidence. 13. Declaration: I Mr./Mrs./Dr. ...................................................................................................... Father / Mother / Guardian of Master / Miss ................................................................................... seeking admission in class ....................... for the session ................................ do hereby solemnly affirm and declare that information given above are true and correct to the best of my knowledge. I understand that my son / daughter / ward admission and / or test will be rejected / cancelled if any of the information given above are found / deducted false / incorrect at any stage before and after the admission / test or even during the currency of the session. I also understand that it is my prime duty to deposit the school / hostel fees and other dues in time, failing which penalty as per school rule will be imposed one me. Signature of the Candidate Signature of Father / Mother / Guardian Date: ....................................................................... Full Name: .............................................................. Address: ................................................................. ................................................................................ Tel No. .................................................................... FOR OFFICE USE Name: ........................................................................................................ Class: ........................................ All the following documents have been checked and verified from the originals and found correct: (i) Date of Birth (ii) Character Certificate (iii) Mark Sheet (iv) Character Certificate Dealing Assistant Date ........................ Admission Incharge Admission granted to Class ............................ Section .......................... with S.R. No. ............................... for the Academic Session .................................... Date ........................ Principal / Headmistress Ayesha Tarin Modern Public School (+2), Aligarh APPLICATION FOR HOSTEL S.No. .............. (for office use) CLASS.......................... SESSION 201..... - 201..... Paste recent most Instructions: All the details must be filled in CAPITAL Letters. Passport size photograph 1. Name of the Candidate: ................................................................................................................................... of the candidate 2. Date of Birth (in words): ................................................................................................................................. (in figures): ................................................................................................................................ 3. Place of Birth: ................................................ Religion: ......................................... Caste: ............................ 4. (a) State of Domicile: ..................................................... (b) Nationality: ...................................................... 5. Parents Particulars: Paste recent most (a) Father (a) Mother Paste recent most Passport size ............................................................... Passport size ............................................................... photograph Qualification: ............................................................... photograph ............................................................... Name: Profession of the Father ............................................................... of the Mother ............................................................... 6. Address: (a) Permanent (b) Correspondence ............................................................... ............................................................... ............................................................... ............................................................... ............................................................... ............................................................... Tel. No. with STD ................................. Tel. No. with STD ................................. Mobile No.: ........................................... Mobile No.: ........................................... 7. Local Guardian Particulars: Paste recent most (a) Name: ..........................................................., (b) Relation: ............................................................ Passport size (c) Address: .................................................................................................................................................... photograph ......................................................................................................................................................................... of the Mother Tel. No. ................................... Mobile. No. ................................... 8. (a) Is your son / ward suffering from any chronic disease and taking medicine? Yes / No. (b) If yes, please provide details with full information duly supported by documentary evidence. 9. Declaration: I Mr. / Mrs. / Dr. .................................................................................... Father / Mother Guardian of Master ............................................................................ seeking admission in class .......................... for the session ........................ do hereby solemnly affirm and declare that my son will abide by all rules and regulations of the hostel as laid down from time to time. I take full responsibility of his good conduct and behaviour throughout his stay in the hostel / school. I understood that my son will be given due punishment of any subversive of law and order. I also understand that I am full responsible for the payment of all hostel / school fees and other dues will in time failing which my son will be suffer. I further declare that I will also follow the hostel rules as far as visit of Parents / Guardians is concerned. Signature of the Candidate Date: ....................................................................... Signature of Father / Mother / Guardian Full Name: .............................................................. Address: ................................................................. ................................................................................ Tel No. .................................................................... ADMISSION CARD (For Class Teacher) Photo En. No./S.R. No. Class: _________________ Session: _________________________ Name: _________________________________ D.O.B. ____________ Father’s Name: ____________________________________________ Mother’s Name: ____________________________________________ Permanent Address: _________________________________________ Phone No.: ________________________________________________ Day Scholar/Boarder: __________________ Bus Route No.: _________ Principal / Head Mistress HALL TICKET (For Admission Test) Name: __________________________________________ Photo Class: __________________ Roll No.: ________________ (Issued by the office) Father’s Name: _____________________________________________ For Office Use Only Specimen Sign. of the Candidate Fee: Reg. No. Sign. Dealing Assistant S.No. Class Date Sign. Adm. Incharge Time Sign. of Candidate Sign. of the Invigilator
© Copyright 2024