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                                                              ADMISSION FORM FOR CLASS XI

                                 KALIKAPUR  HIGH  SCHOOL (H.S.), P.O. -BARAKASHIPUR,  DIST.-DAKSHIN  DINAJPUR,  PIN-733102

                                                          (TO BE  FILLED  BY SCHOOL OFFICE)

        SERIAL  NO--                                                                                                 ROLL  NO---

      DATE OF  RECEIPT---                                                                                  DATE  OF ADMISSION--

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                                                                (TO BE  FILLED BY THE CANDIDATE)

1)FULL NAME OF THE STUDENT(IN BLOCK LETTER)--

2)DATE  OF BIRTH-------------------------------------

3) AGE AS ON 01.07.202-                                   YEAR                              MONTH                                      DAY

4)a) NATIONALITY---------------------------------4b)RELIGION------------------------------------------4c)CASTE-----------------------------------

5. HOME  ADDRESS--a)VILL--------------------------------------------------b)P.O.--------------------------------------------------------c)Dist.---------------------------------------

   d)PIN----------------------------------------------------e)MOBILE  NO---------------------------------------------f)AADHAR  CARD NO--------------------------------------------

6)  FATHERS  NAME------------------------------------------------------------------------------------

7)MOTHERS  NAME------------------------------------------------------------------------------------

8)GUARDIANS NAME----------------------------------------------------------------------------------

9)FATHERS VOTER  CARD  NO-------------------------------------------------------------------

10) LOCAL GUARDIANS NAME  &  ADDRESS-----------------------------------------------------------------------------------------------------------------------------------------------

                   -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

11)NAME OF THE BOARD FROM WHICH THE STUDENT PASSED THE MADHYAMIK PARIKSHA ----------------------------------------------------------------

11(a) YEAR OF PASSING-------------------, b)FROM SCHOOL-----------------------------------------------------------------------------

   c)DIST.--------------------------------------------------- d)ROLL ----------------------------------- e)NO--------------------------------------WITH RESULT OF M.P.------

 

BENG   ENGB     MATH   P.SC.    L.SC.    HIST.     GEO                          TOTAL

12.) CLASS TO WHICH ADMISSION SOUGHT------------------------------

13)  SUBJECT TO BE TAKEN------a) BENGALI     ,b) ENGLISH  c)------------------------------------,d)  ----------------------------------

e)------------------------------------------f)FOURTH SUBJECT, if any-----------------------------------------------

14) IN CASE THE STUDENT PREVIOUSLY ADMITTEDE INTO THIS SCHOOL---

a)YEAR--------------------------------b) CLASS-------------------------------, c) ROLL NO------------------------------

  DATE OF ADMISSION-----------------------------,                              SIGNATURE OF STUDENT---------------------------------------------------------------------

                                                       SIGNATURE OF GUARDIAN-----------------------------------------------------------------------------------------------------

 

                                                                                                SIGNATURE OF HEADMASTER

                                                                   ADMISSION FORM  (FOR CLASSES V TO IX )                                  SERIAL NO-

                                 KALIKAPUR  HIGH  SCHOOL( H.S.), P.O. BARAKASHIPUR , DIST. DAKSHIN  DINAJPUR,  PIN-733102

1)  NAME OF THE STUDENT.--

2)  DATE OF BIRTH -(ENCLOSE BIRTH CERTIFICATE)--

3) AGE OF STUDENT AS ON 01.01.202-- a)YEAR--                         b) MONTH-                           c)  DAYS--

4) AADHAR  CARD NO-

5) CASTE  CERTIFICATE  NO--

6)  MOBILE  NO--

7)  FOR WHICH CLASS APPLIED FOR  ADMISSION --

8) FIRST ADMISSION OR TRANSFER FROM OTHER SCHOOL--

9) IF IT IS TRANSFER FROM OTHER SCHOOL THEN MENTION--

a)  NAME OF THE LAST SCHOOL                                                                                                      b) LAST CLASS STUDIED -

c) RESULT OF THE LAST CLASS ---

10) NAME OF THE FATHER --

11)NAME OF THE MOTHER --

12)NAME OF THE LEGAL GUARDIAN--

12(a) VOTER CARD NUMBER NO OF THE GUARDIAN--

12(b) CASTE--                                         12(c)  SUB-CASTE-                                      12(d) RELIGION--                                   12(e) NATIONALITY--

13) ADDRESS OF THE  STUDENT -

14) BANK DETAILS OF THE STUDENT-

a)NAME OF BANK-

b) BRANCH NAME--

c) BANK A/C NO--

d)   IFSC--

15) YEARLY INCOME OF THE GUARDIAN --

15(a) WHEATHER EMPLOYED----- YES/NO

16) TO WHICH CLASS ADMITTED-

17) WHEATHER ADMITTED IN SCHOOL HOSTEL--

 

 

SIGNATURE OF THE GUARDIAN                                                                                     SIGNATURE OF THE HEADMASTER

(ATTESTED COPY OF THE MARKSHEET AND CERTIFICATES TO BE SUBMITTED WITH THE APPLICATION FORM)