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From No.                                                                                                                 

RAHMATNAGAR

IQBAL ACADEMY HIGH SCHOOL (H.S.)

P.O+BLOCK – ANDAL, SUB DIVISION-DURGAPUR, DIST-PASCHIM BARDHAMAN, PIN-713321

M.P. Code : H5-068, H.S. Code No. 204264

ADMISSION FORM

FOR THE SESSION OF 201    -201

 

 

  1. Name of the Applicant: ................................................................................................................................

(In Block Letter)

  1. Address : .......................................................................................................................................................

....................................................................................... Mob : .....................................................

  1. a) Father’s Name: (In Block Letter).................................................................................................................

b) Address :...................................................................................................................................................

....................................................................................... Mob : .....................................................

  1. Mother’s Name: (In Block Letter)...................................................................................................................

  2. (a) Guardian’s Name (If Applicable) : ...........................................................................................................

(b) Address : ..................................................................................................................................................

(c) Occupation : ..........................................................................................................................................

(d) Relationship with student: ......................................................................................................................

6. Name of the School Last Attended: ...............................................................................................................

(A Certificate from Headmaster/ Headmistress to be enclosed)

 

  1.  

(Attested Xerox Copy of Admit Card of Madhyamik Examination to be attached)

 

b) Caste .......................... c) Race ......................... d) Religion .......................... e) Mother Tongue ................

 

  1.  

 

9. a) Migration and age certificate, in case of a migrated student........................................................................

 

b) Details of migrated Students :

I) State ............................................................................................................................................................

II) School .........................................................................................................................................................

III) Class in which He/She studied....................................................................................................................

10. Result of Madhyamik Examination :

a) Division ...................................... b) Year ................................................ c) Roll ........................................

 

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Form No.

Received by: ................................................................................

(Write the name)issued by.......................................................

(Office )

  1. Marks obtained in the Madhyamik Examination :

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Physical Science

Life Science

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Grand Total

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Attested Xerox Copy to be attached

  1. Subject taught in this school

  1. Language (Compulsory)                         1. Urdu                        2. English

  2. Elective Subjects             : 1. ...........................................................

: 2. ...........................................................

: 3. ...........................................................

  1. Additional Subject :       : 1. ...........................................................

Elective Subjects taught :-

Arts :- History, Pol. Science, Geography, Economics, Computer Application, Education

Science :- Physics, Chemistry, Mathematics, Biological Science, Computer Application

 

  1. Declaration : I agree to abide by all the rules and regulation of the institution.

 

 

 

............................................................                                                            ............................................................

Counter Signature of Father/ Guardian                                                              Full Signature of the student

 

 

 

Remarks of Head Master