Adm Form - Ayesha Tarin Modern Public School

S.No. ..............
(for office use)
Ayesha Tarin Modern Public School (+2), Aligarh
APPLICATION FOR REGISTRATION & ADMISSION TEST
CLASS.......................... SESSION 201..... - 201.....
Instructions:
.
(a) All the details must be filled in CAPITAL Letters.
(b) Duly filled Application Form along with the following attachments be sent/submitted to the concerned section of
the School Office:
i. Demand Draft of ` 500/- in favour of AYESHA TARIN MODERN PUBLIC SCHOOL payable at Aligarh.
ii. Duly attested photocopies of the Date of Birth and the Class Passed from the School last attended.
(c) Transfer / Migration Certificate will be submitted in Original duly countersigned by the competent authority at the
time of completing admission.
Paste recent most
Passport size
photograph
of the candidate
1. Name of the Candidate: ...................................................................................................................................
2. Date of Birth (in words): .................................................................................................................................
(in figures): ................................................................................................................................
3. Place of Birth: ................................................ Religion: ......................................... Caste: ............................
4. (a) State of Domicile: ..................................................... (b) Nationality: ......................................................
5. Parents Particulars:
(a) Father
Name:
Paste recent most
(a) Mother
Paste recent most
...............................................................
Passport size
...............................................................
Passport size
photograph
Qualification: ...............................................................
photograph
...............................................................
Profession
of the Father
...............................................................
of the Mother
...............................................................
6. Address:
...............................................................
...............................................................
...............................................................
...............................................................
...............................................................
...............................................................
Tel. No. with STD .................................
Tel. No. with STD .................................
Mobile No.: ...........................................
Mobile No.: ...........................................
7. Local Guardian Particulars:
(a) Name: ....................................................................., (b) Relation: ............................................................
(c) Address: ....................................................................................................................................................
............................................................... Tel. No. ................................... Mobile. No. ...................................
8. (a) Class/Std. Pass .................................
(c) % of Marks: .........................................
(b) Year of Passing: .........................................
(d) Medium of Instruction: .............................
(e) School Name with Address: ......................................................................................................................
9. Any Brother and / or Sister studying in the school? If yes, give details:
(a) Name: ...................................................
Class ................................................................
(a) Name: ...................................................
Class ................................................................
(a) Name: ...................................................
Class ................................................................
10. (a) School Transport facility required:
Yes / No
(b) If yes, Name of the Bus Stop............................................................................ (Pl. refer Bus Route
11. Plan)
Hostel Facility required (For Boys only fro Classes III - XII):
Yes / No
(a) Is your son/daughter/ward suffering from any chronic disease and taking medicine?
Yes / No
(b) If Yes, Please provide details with full information duly supported by documentary evidence.
13. Declaration:
I Mr./Mrs./Dr. ...................................................................................................... Father / Mother / Guardian
of Master / Miss ................................................................................... seeking admission in class
....................... for the session ................................ do hereby solemnly affirm and declare that information
given above are true and correct to the best of my knowledge. I understand that my son / daughter / ward
admission and / or test will be rejected / cancelled if any of the information given above are found / deducted
false / incorrect at any stage before and after the admission / test or even during the currency of the session. I
also understand that it is my prime duty to deposit the school / hostel fees and other dues in time, failing
which penalty as per school rule will be imposed one me.
Signature of the Candidate
Signature of Father / Mother / Guardian
Date: .......................................................................
Full Name: ..............................................................
Address: .................................................................
................................................................................
Tel No. ....................................................................
FOR OFFICE USE
Name: ........................................................................................................ Class: ........................................
All the following documents have been checked and verified from the originals and found correct:
(i)
Date of Birth
(ii)
Character Certificate
(iii)
Mark Sheet
(iv)
Character Certificate
Dealing Assistant
Date ........................
Admission Incharge
Admission granted to Class ............................ Section .......................... with S.R. No. ...............................
for the Academic Session ....................................
Date ........................
Principal / Headmistress
Ayesha Tarin Modern Public School (+2), Aligarh
APPLICATION FOR HOSTEL
S.No. ..............
(for office use)
CLASS.......................... SESSION 201..... - 201.....
Paste recent most
Instructions: All the details must be filled in CAPITAL Letters.
Passport size
photograph
1. Name of the Candidate: ...................................................................................................................................
of the candidate
2. Date of Birth (in words): .................................................................................................................................
(in figures): ................................................................................................................................
3. Place of Birth: ................................................ Religion: ......................................... Caste: ............................
4. (a) State of Domicile: ..................................................... (b) Nationality: ......................................................
5. Parents Particulars:
Paste recent most
(a) Father
(a) Mother
Paste recent most
Passport size
...............................................................
Passport size
...............................................................
photograph
Qualification: ...............................................................
photograph
...............................................................
Name:
Profession
of the Father
...............................................................
of the Mother
...............................................................
6. Address:
(a) Permanent
(b) Correspondence
...............................................................
...............................................................
...............................................................
...............................................................
...............................................................
...............................................................
Tel. No. with STD .................................
Tel. No. with STD .................................
Mobile No.: ...........................................
Mobile No.: ...........................................
7. Local Guardian Particulars:
Paste recent most
(a) Name: ..........................................................., (b) Relation: ............................................................
Passport size
(c) Address: ....................................................................................................................................................
photograph
.........................................................................................................................................................................
of the Mother
Tel. No. ................................... Mobile. No. ...................................
8. (a) Is your son / ward suffering from any chronic disease and taking medicine?
Yes / No.
(b) If yes, please provide details with full information duly supported by documentary evidence.
9. Declaration:
I Mr. / Mrs. / Dr. .................................................................................... Father / Mother Guardian of Master
............................................................................ seeking admission in class .......................... for the session
........................ do hereby solemnly affirm and declare that my son will abide by all rules and regulations of the hostel as
laid down from time to time. I take full responsibility of his good conduct and behaviour throughout his stay in the hostel
/ school. I understood that my son will be given due punishment of any subversive of law and order. I also understand that
I am full responsible for the payment of all hostel / school fees and other dues will in time failing which my son will be
suffer. I further declare that I will also follow the hostel rules as far as visit of Parents / Guardians is concerned.
Signature of the Candidate
Date: .......................................................................
Signature of Father / Mother / Guardian
Full Name: ..............................................................
Address: .................................................................
................................................................................
Tel No. ....................................................................
ADMISSION CARD
(For Class Teacher)
Photo
En. No./S.R. No.
Class: _________________ Session: _________________________
Name: _________________________________ D.O.B. ____________
Father’s Name: ____________________________________________
Mother’s Name: ____________________________________________
Permanent Address: _________________________________________
Phone No.: ________________________________________________
Day Scholar/Boarder: __________________ Bus Route No.: _________
Principal / Head Mistress
HALL TICKET
(For Admission Test)
Name: __________________________________________
Photo
Class: __________________ Roll No.: ________________
(Issued by the office)
Father’s Name: _____________________________________________
For Office Use Only
Specimen Sign. of the Candidate
Fee:
Reg. No.
Sign. Dealing Assistant
S.No.
Class
Date
Sign. Adm. Incharge
Time
Sign. of Candidate
Sign. of the Invigilator