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INSTITUTION CODE (H.S) : 112191         DICE CODE : 19100806704                    INDEX NO. D1-026

                                                         CHANDERGHAT HIGH SCHOOL(H.S)

                                               P.O. : CHANDERGHAT, DIST. NADIA, PIN : 741160

                                                                         ESTD : 1964

                                e-mail ID. : chshs19100806704@gmail.com   * Mob. No. ; 9775001907

 

                                ADMISSION FORM FOR THE YEAR : ____________   FOR CLASS : _______

1.   Student's ID. (Collect from I.Card/Previous Attendance Register): 

         *[Office use only for New Student]

2.   Name of Applicant in Capital Letters :…………..……….………………………………………………………………….

3.  (a) Father's Name in Capital Letters :…………..……….………………………………………………………………….

      (b) Ocupation of Father :[√]Service Business Others 

     .(C) Qualification of Father :

4.   (a) Mother's Name in Capital Letters :………………………………………………………………………………….

       (b) Ocupation of Mother :[√]Service Business Others 

      .(C) Qualification of Mother :

5.   Annual Income of Parent :Rs. ..…………/- (in word: Rupees …..….…….....………………………………………..)

6.   Address :   Vill : ………………………………………………….P.O. : …………………………………………………………

      Dist. : …………………..……………..      P.S. : …………………………………….      PIN : ……………………………………….

7.   Date of First Admission in this School (Follow Previous I.Card) :DDMMYYYY

        *[Office use only for New Student]   

8.   Date of Birth :DDMMYYYY

   

9.   (a) Name of Previous School : ………………………………………………………………………………………………………….

       (b) Class(Previous) : ………….  .(c) Percentage of Marks(%) : ……………….  (d) Class(Present) : …………. 

10.  Sec. ('A' for Boys & 'B' for Girls) : 

11.  Roll No. (For Office use only) : 

12.  (a) Caste : …………………………………… (b) Sub-Caste : …………………………..

13.  (a) APL : (b) BPL : [ √ & Submit Document for BPL]

       .(c) Mobile No.    

        (d) Aadhaar No.   

                                                                                                                    

PASSPORT SIZE COLOUR PHOTO OF STUDENT

14.  (a) Bank A/C. No. (If any) : 

         *[Mandatory for Gorls , SC , ST , & OBC / any kind of Scholarship Holders] 

       (b) I.F.S. Code : 

       (c) Bank Name : ……………………………………………………………………

       (d) Branch Name : ………………………………………………………………

       (e) Kanyashree ID. : 

15.  Declaration from Guardian : No Data will be changed later.

………………………………………………Office seal

 

...............................................                              ..............................................

Signature of Guardian                                           Signature of Student 

Date :                                                                    Date : 

Sl.No. :                               CHANDERGHAT HIGH SCHOOL (H.S.)

                                                   P.O. Chanderghat , Dist. Nadia

                                  APPLICATION FORM FOR ADMISSION IN CLASS - XI

                            Year : 20…….. - 20……..RECENT COLOUR PHOTO OF APPLICANT

                                                    (USE CAPITAL LETTER ONLY)

1.  Student's ID. (For Office use only) : 

2.  Name of the Applicant (Student) :……………………………………………………………………

3.  Father's Name :……………………………………………………………………………………………

4.  Mother's Name :……………………………………………………………………………………………

6.  Annual Income of Parent :  ………………/- (in words: …………………………………………………………………………)

7.  Address in Full : 

Vill :…………………………..………………….  P.O. :…………..………………………………….     P.S. :……..………………………..      

Dist. …………………...………………………...         PIN : 74……………………………...

8.  Date of Admissiom  (For Office use only) :DDMMyyyy

   

9. (a) Date of Birth DDMMyyyy(b) Blood Group : 

as per ADMIT CARD:   [with document]

10.  (a) Name of Previous School : ………………………………………………………………………………………………………..

(b) Year of Passing[MP] :  20………… [c] Percentage of Marks[MP] :            %

(d) Marks Obtained with Grade [Self Attested Copy of Mark Sheet must be Enclosed] :

BengaliEnglishMathematicsLife SciencePhysical ScienceHistoryGeographyAdditional

MarksGradeMarksGradeMarksGradeMarksGradeMarksGradeMarksGradeMarksGradeMarksGrade

                

(e) Subjects to Study in This School :-

[i] Language (Compulsory) : 1. Bengali , 2. English , [ii] Elective Subjects (Please √ Any Three) :  

                

i) History ii) Sanskrit iii) Geography  

  

 iv) Philosophy v) Political Science  

                

[iii] Optional Elective (Mention the Name of the Subject) : 

11. Sec. ('A' for Boys & 'B' for Girls :       12. Roll No. (For Office use only) : 

13.  (a) Cast : ………………………………………………..     (b) Sub-Cast : …………………………………………………...

*(Please Submit a Self Attested Copy if Reserved)

14.  (a) APL / BPL  [ Please √ and Submit BPL List if BPL]

(b) Mobile No :          

.(c) Aadhaar No.    

15.  (a)Bank A/C. No.        

*[Mandatory for Girls, SC, ST, OBC & any kind of Scholarship Holders]

(b) I.F.S.Code : 

.(c) Bank Name : (d)  Branch Name : 

16.  Kanyashree ID.(Mandatory for Unmarried Girls): 

* Declaration  : I agree  to abide by all the rules & regulation of the institution and no DATA , 

                                 given in Application Form will be changed later.

 

…………………………………                  ….…………………………………..

Signature of Guardian                                       Signature of Student

Date :                                                                  Date :