
CHAPUI SAWRA VIDYASAGAR HIGH SCHOOL
Estd: 2010-2011
P.O: KALIPAHARI, Dist: PASCHIM BARDHAMAN, PIN: 713339
ADMISSION FORM
Note: Please use capital letters only
A. INFORMATION OF THE STUDENT
NAME: ………………………………………………………………………………………………………….....................
GENDER: MALE/ FEMALE DATE OF BIRTH: ....................................................
RELIGION: …………………………………………........... CASTE: SC/ ST/ OBC/ GEN (Tick the Right one)
AADHAAR NO: …………………………………………… PHONE NO.: ................................................................
LAST INSTITUTION ATTENDED:……………………………………………………………………………………..
CLASS TO WHICH ADMISSION IS DESIRED: …………………………………………………………………........
PRESENT ADDRESS:……………………………………………………………………………………………………...
………………………………………………………………………………………………………………………………………………………………........................................................................................................................................................
PERMANENT ADDRESS: ……………………………………………………………........................................................
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B. FAMILY INFORMATION
i) FATHER’S NAME:...............................................................................................................................................................
OCCUPATION: …………………………………………………………………………………………................................
ii) MOTHER’S NAME:…………………………………………………………………………………………………….....
OCCUPATION: …………………………………………………………………………………………................................
iii) GUARDIAN’S NAME:………………………………………………………………………...........................................
RELATION WITH THE STUDENT:…………………… OCCUPATION: ………………………...............
C. ENCLOSURES :( All documents are mandatory at the time of admission)
I) BIRTH CERTIFICATE OR SIMILAR DOCUMENT IN SUPPORT OF DATE OF BIRTH
II)TRANSFER CERTIFICATE-ORIGINAL COPY
III)AADHAAR CARD COPY OF STUDENT
IV)CASTE CERTIFICATE
V)RECRENT PASSPORT SIZE PHOTO OF THE STUDENT (4 COPIES)
DECLARATION:
I declare that my son/daughter will come regularly in school and will abide by the rules and regulations of the school. Otherwise, I shall abide by the decision of the management.
Signature of Parent/Guardian
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OFFICE USE ONLY
NAME OF THE STUDENT: ………………………………………………………………………………………………....
Signature of the Admission co-ordinator Signature of the Head of the Institution
Date Date
Admission no. & date:................................................................