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                                               ADMISSION FORM

                                        KHASMORAH HIGH SCHOOL          

                                        (Higher Secondary-XI & XII Class)                      

                                     P.O.-KHASMORAH , DIST.-HOWRAH

Last Date of Submission :                                                    For office use only

                                                                                             Class-          Section-        Roll-

1.Name (In Block Letter ):--------------------------------------------------------------------------

2.Address :   (a) Permanent :----------------------------------------------------------------------

                        (b)Present :---------------------------------------------------------------------------

                        (c)Phone or Mobile of Guardian :----------------------------------------------

3.Date of birth according to the Madhyamik Pariksha Admit Card (attested copy

    enclosed ) :------------------------------------------------------------------------------------------

4. (a) Nationality :-----------------------------------  (b) Religion :-------------------------------

(c) Whether a Scheduled Cast / Scheduled Tribe / O.B.C. / Minority :(Give tick √ )

If yes , Name of the Cast / Tribe :----------------------------------------------------------------

5. Father’s Name & Address :---------------------------------------------------------------------

6. Guardian’s Name & Address :------------------------------------------------------------------

     & Contact No.  :------------------------------------------------------------------------------------

7. Mother’s Name :-----------------------------------------------------------------------------------

8. Class to which the candidate applies for admission :------------------------------------

9.(a)Result of the Madhyamik Pariksha or its equivalent(attested copy enclosed)

    (b)Combination No. opted by the student :------------------------------------------------

     (c)Subject to be taken up in class XI / XII :

      (i)Bengali          (ii)English      (iii) -------------------------------------------------------------

      (iv)-----------------------------------------------(v)-------------------------------------------------

      (vi) ---------------------------------------------------------------------------------------------------

                                                       DECLARATION

I agree to abide by the rules and regulations as framed time to time by the auth-

orities of the institution and maintain discipline in all fields of activities organis-

ed by the institution. I also declare that nothing directly or indirectly against the

interest of the institution would be done by me .

 

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

        (Signature of the Guardian )                                 (Signature of the candidate)

Elective Subjects :Physics,Chemistry,Mathematics,Biology,History, Geogragphy,

Philosophy,Political Science,Sanskrit,Accountancy,Business Studies,Nutrition,

Law & Auditing,Environmental Studies, Costing & Taxation.