
SITAPUR ENDOWMENT SENIOR MADRASHA (FAZIL)
(Established during the reign of Nawab Alivardi Khan in 1751) GOVERNMENT RECOGNISED AND AIDED
Index No. 07-05-03-01-032
P.O-JAGATBALLAVPUR, P.S - JANGIPARA, Dist - HOOGHLY WEST BENGAL, PIN-711408
Phone: 9564371236/9732841703/03368263418
Class - (I-XII)
Admission Application Form
1. Name ....................................................................................... Aadhar No......................................
2. Father's name........................................................... Occupation......................................................
3.Mother's name ...............................................................................Social Category (General/ OBC-A/OBC-B).............................................
3. Address:-........................................................................................
.........................................................................................................Pin.......................
4. Date of Birth............................................................................................................
5. BS Portal ID No. .....................................................................Previous School Name ................................................
6. Admission Date .................................................................................Admission Class...................................................
7. Bank Details: Banks Name...............................................................................Branch.........................................
A/C No. ............................................................................ IFS Code.......................................................
8. Guardain's Name..................................................................... Educational Qualication...........................................
Annual Income...............................................................................
9. For Fazil Admission
9.1. Alim Examination Roll........................................... No...........................................Registration no. ............................... Year.................
Pass out Year...............................................................Optional subjects History / Geography...................................
Signature of parent / Guardain with date Signature of Superintendent/ TIC