ADMISSION FORM FOR CLASS     -V/ XI

Affix 

Name of School

:

                           TRAQQUI-E-URDU HIGH SCHOOL(H.S.)

recent

U-DISE Code

:

1

9

1

6

1

3

1

5

8

0

2

Color

Student Code

:

Photo

A--

Basic Information:-

1

Name

:

2

Date Of Birth

:

3

Gender

:

MALE

FEMALE

4

Social Category

5

Religion

:

I

S

L

A

M

6

Aadhaar No.

:

9

Blood Group

:

11

Health ID

:

12

Identification Marks :-

B--

Educational Information :-

1

Academic Year

:

2

Admission No. :

3

Admission Date

:

_

_

4

Medium

:

U

R

D

U

5

Present Class

:

Section

Roll No. :

Stream :

A

R

T

S

6

Previous Class

:

Section

Roll No. :

Stream :

N/

A

C--

Contact Information:-

1

Address

:

2

Habitation/Locality:

3

District

:

H

O

W

R

A

H

4

Block/Municipality :

5

Panchayat

:

6

Post office

:

7

Police Station

:

8

Pin Code

:

7

1

1

9

Contact No.

:

10

E mail ID

:

D--

Guardian's Details:-

1

Father's Name

:

2

Mother's Name

:

3

Guardian's Name:

4

Relationships

:

5

Annual Family Income

6

Guardian Qualification  :

E--

Others Information:-

1

BPL Status

If ,Yes

2

BPL No.

3

Children with Special  Need

If ,Yes

4

Type of Disability

F--

 Bank Details:-

1

Bank Name

:

2

Branch Name

:

3

IFSC Code

:

4

A/C, No.

:

G--

For Students of grades XI

 Name of the Board :

W

B

B

S

E

/

W

B

B

M

E

/

W

B

C

H

S

E

 Marks obtained in the last qualifing examination :

Subject

1st Lang.

2nd Lang.

Math

Phy.Sc.

L.Sc.

Hist.

Geog.

Addl.

Full Marks

1

0

0

1

0

0

1

0

0

1

0

0

1

0

0

1

0

0

1

0

0

1

0

0

Marks Obtained

Grade Awarded

Grand Total

Percentage (%) :

(Total marks obtained excluding additional subject)

Subject offered in Class-XI ,ARTS :URDU (1ST Lang.), ENGLISH (2ND Lang.)

ELECTIVE SUBJECTS : (a) POL.SC., (b) HIST., ( c ) EDN., (d) Opt.El. …….

(Signature of Father/Mother )

(Signature of Candidate)

(Signature of HOI)