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     BHIMPUR SWAMIJI VIDYAPITH (H.S.)

         GOVT. SPONSORED CO-EDUCATIONAL INSTITUTION, ESTD-1954.

         P.O.+P.S.-BHIMPUIR,DIST.-NADIA,WEST BENGAL,PIN-741167.PH.NO:03472-264316

                         INDEX NO: D1-1022 (M.P/S.E), INSTITUTION CODE:112110 (H.S.),                      

                                              Email: bhimpursv@gmail.com

     ADMISSION FORM TO CLASS XI (ELVEN)ONLY(F0R UPLADING)

                                                                  FOR THE SESSION-202…-202…

 

Paste student’s

Passport size

Colour photo &

Sign on lower part.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  e-Portal Id No.(of BANGLARSIKSHA PORTAL)-14   Digits:

Paste guardian’s

Passport size colour photo &

Sign on lower part.

                                          [FILL IN WITH BLOCK / CAPITAL LETTERS ONLY]

            Student’s Name                                 Father`s Name                                           Mother`s Name

 

 

 

Name Of Local Guardian      Father`S Occupation           Annual Income Of Family     Guardian`S Qualification

 

 

 

 

  

             Caste-

           Religion-

   Gender-Male/Female-

        Date of Birth-

 

 

 

 

 

  Blood Group-

            Aadhaar No-

 Valid Contact No(Mob:)

    Mother Tongue

 

 

 

 

 

BPL –YES / NO ?

                If yes,Write BPL Id No-

       Identification Marrk if Any ?

 

WB

 

 

      Kanyashree ID if Any (Female) ?

CWSN –YES / NO ?

If Yes, Write Type of Disability.

 

 

 

PERMANENT ADDRESS:                                            PRESENT ADDRESS:

Road/Para-

 

Road/Para-

 

Vill./Town-

 

Vill./Town-

 

P.O.-

 

P.O.-

 

P.S.-

 

P.S.-

 

Block-

 

Block-

 

G.P.-

 

G.P.-

 

Dist.-

 

Dist.-

 

State-

 

State-

 

PIN-

 

PIN-

 

BANK ACCOUNT DATAILS:-

Name of the Bank-

Branch Name-cum-Address-

IFSC CODE-(Fifth figure is Zero)-

 

 

 

MICR CODE of Bank Branch-

Account Number (Write Carefully !)

Aadhaar No. Seeded-YES/NO-

 

 

 

ADMISSION TO CLASS XI(ELEVEN):-

Year-

Date-

Stream-Science /Arts-

LAST EXAMINATION DETAILS; MADHYAMIK (SECONDARY):-

Previous School Name-

M.P.(S.E) Regn. No.-

M.P.Admit Card Roll & No.-

 

 

                         /

LAST EXAM.MARKS DETAILS:-

Bengali-

English-

Math.-

P.Sc.-

L.Sc.-

History-

Geogr.-

Addln.-

Marks Obtained-

% of Marks(with decimel)-

 
         

SUBJECTS` COMBINAION IN CLASS-XI:SCIENCE/ARTS-GEO./ARTS-GENERAL:-

Compulsory-I: Bengali(FL)

Compulsory-II: English(SL)

Elective-III:

Elective-IV:

Elective-V:

Elective-VI:

Full Signature of the Guardian with Date:-                             Full Signature of the Student with Date:-

 

 

                                         

 

                                                                   [FOR OFFICIAL USE ONLY]

ADMISSION REGISTER SERIAL NO . WITH  DATE:-

NEW ADMITTED CLASS/SECTION/ROLL NO:-

 

                        /                        /

REMARKS IF ANY:

 

VERIFIED BY          :

REMARKS IF ANY BY ADMN. OFFICIAL & SIGN.