
ENTALLY ACADEMY Index No. A1-021
Govt. Sponsored High School for Boys. Phone No. 9836043451
LOGO (Recognised by the West Bengal Board of Secondary Education) Stamp size
Excelsior, Culture, Training, Discipline. PHOTO
23, GIRISH CHANDRA BOSE ROAD, KOLKATA-700014.
ADMISSION FORM
Admission No. EA/ Class..................................
1. Name of the Pupil (In Block Letters).......................................................................................................................................
Nationality............................................................... Religion...................................................................................................
2.(a) Father's Name (In Block Letters)........................................................................................................................................
Address...............................................................................................................................................................................
P.O............................................... P.S..................................................... PIN......................................................................
Ward No................................... Borough No.............................................. Telephone No...................................................
Occupation...........................................................................................................................................................................
(b) Mother's Name (In Block Letters).........................................................................................................................................
3. Guardian's Name.......................................................................................................................................................................
Address......................................................................................................................................................................................
Occupation................................................................................................................................................................................
Relation with the pupil...............................................................................................................................................................
4. Class to which admission is sought..........................................................................................................................................
5. Date of Birth (according to T.C./Birth Certificate)......................................................................................................................
6. Age on the date of application..................................................................................................................................................
7. Whether the pupil has Transfer Cerficate or any other evidence of age...................................................................................
8. Whether the pupil belongs to Schedule caste or Schedule Tribe or O.B.C., if any...................................................................
Mention the Sub-Caste
(Proof is to be submitted for SC/ST/OBC)
9. Whether the student is specially disabled :
10. Class & Name of the previous Institution where the pupil studied........................................................................................
I Solemnly declare that the particulars about Sri......................................................................................................................
.......................................... are true and correct. My ward I must abide by the rules and regulations of this Institution.
Signature of the Pupil Signature of father or Guardian
Date............................ Date.......................................