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        RABINDRA VIDYALAYA (F.P.) SCHOOL 

           Recog.No./Date :- 5989/SC/P/14.07.1973

SRINAGAR, CHANDMARI, P.O.-ASANSOL, DIST. -PASCHIM BARDHAMAN 

UDISE CODE :-19261002315          SCHOOL NO. :- 77

                 ADMISSION FORM 

......................................................................1. Student's Name : ........................    

2. Father's Name : ...........................

3. Occupation : ..................................

4. Address : ........................................

5. I) Name of Guardian : .......................

     II) Guardian's Address : ........................

     III) Relation with Student : ......................

6. I) Date of Birth : ........./............/............

   II) Age on the day of Admission : ............

7. Cast : Gen .□ , SC □  ,OBC □, (Please Tick )

8. Religion :Hindu  □ ,Muslim □ ,Christian □ ,Other  □ .

9. Admission in class : .......................

10.Transfer Certificate  (In Case of Student Studied earlier ):-

11.Mobile No.:.................... 

12.I do here by declare that the above information given by me, are true. 

Date. .............       Sign of Parent /Guardian

.......................................................................               For Office  Use Only 

The student............. has illegible for admission in class.............................

Date.........   School Seal       Signature of Head Teacher