
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.