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GOPALPUR HIGH SCHOOL
ADMISSION FORM
Admission Number.......................................
Date of Admission......,.................................
Basic information :
1. Name of the Students..............................
2. Date of Birth..........................,...................
3. Birth Regn. no.................,........,.................
4. Sex.........,......... 5. Religion.......................
6. Cast/Subcast ...........................................
7. Nationality.................................................
8. Blood group...............................................
9. Adhar No...................................................
10. Voter Id ...................................................
11. Health I'd.................................................
12. Identification Mark..................................
Educational Information:
1. Admission Year...,.....................................
2. a) Present Class........................................
b) Previous Class ....................................
3. a) Present Roll and Section .....................
b) Previous Roll and Section .....,.............
Contact Information:
1. Address ......,..............................................
2. P.O. ............................................................
3. P.S. ............................................................
4. Block .........................................................
5. Panchayat/ Municipality ..........................
6. District ......................................................
7. Pin No. ......................................................
8. Contact Number......,,................................
Guardian Details:
1. Father's Name .........,................................
2. Mother's Name......,...........,.....................
3. Guardian Name.........................................
4. Relationship with Guardian......................
5. Residential address................................
.....................,.............................................................,...................................................................................................................................
12. Contact Number.....................................
Others:
1. BPL Status/ BPL no..................................
2. Child with special needs...........................
3. Type of Disability...,,..................................
Bank Details:
1 Name of the Bank......................................
2. Branch ......................................................
3. Account Number.......................................
4. IFSC CODE ................................................
Student's Signature Guardian Signature
Date ........................ Date........,................
Approved by.............
Head Master
Gopalpur High School
Date .......,.............
Place....Gopalpur.,....