Application for Admission to Class XI O.S.

Transcription

1 Admission No.: Application for Admission to Class XI O.S. Application No. : Date of Submission : Date of Issue : Acknowledged by : 1 Name of the application (in BLOCK Letters as in the Secondary School Certificate or ICSE as the case may be) 1a Date of Birth dd mm yyyy Sex M / F Age In years 1b Is the candidate a single child? YES / NO 2a Mother Tongue : 2b Nationality : 2c Religion : 2d Category (BC/ MBC / SC /ST/ OBC/ Others-Specify) 3 Do you belong to Minority Community? If YES, Specify the Community Muslim / Christian / Sikh / YES / NO 4 School Last Attended (with Address) Name of Board (Please tick) CBSE / ICSE / State Board / Matric / Others... 5 CBSE Registration No. allotted in Class 9 (for CBSE Students only) 6 Group I Functional English, Maths, Physics, Chemistry, Biology Group II Functional English, Maths, Physics, Chemistry, Computer Science Group III Functional English, Biology, Chemistry, Psychology, Informatics Practices Group IV Functional English, Maths/ Informatics Practices, Accountancy, Business Studies, Economics Group Desired: I Preference: II Preference: III Preference: (Request for change of preference will not be entertained) 7 Extra Curricular Activities / Hobbies

2 8 a. For CBSE Students (Please attach Xerox copies of report cards) English Class Grades obtained in Mathematics Science Social Science b. For other Boards (Please attach Xerox copies of report cards) English Class Grades obtained in Mathematics Science 9 Is the Candidate s Brother / Sister studying in Vidya Estancia? If Yes, mention Name & Class Std. IX SA 1 SA 2 Std. X SA1 Std. IX Std. X Total (out of 300) Annual Exam Quarterly Half Yearly YES / NO 10 Has the candidate s Brother / Sister applied / registered for any other class? YES / NO If Yes, mention Name & Class 11 Father Mother Guardian, If not living with parents Name Residential Address Phone No. Mobile No. ID Occupation Designation Office Address

3 Phone No. Income (p.a.)

4 12. Details regarding appearance for Secondary Examination (10 th Std.) Board : Roll No. Month & Year: DECLARATION We hereby declare that all information given in this application are true and accurate. We agree to forfeit the fees paid in the event of the student leaving the School / not joining after admission. Station: Date : Signature of Student Signature of Father / Mother / Guardian (Strike off whichever is not applicable) ORDER Admit into... Group PRINCIPAL For Office use only Verified: Fees paid Rs. 1. Original Mark Sheet Yes / No 2. Original TC Received Yes / No 3. Copy of Marksheet received Yes / No 4. Copy of CC received Yes / No 5. Copy of Pass Certificate received Yes / No 6. Copy of Migration Certificate received Yes / No Receipt No. 7. Fees paid Yes / No 8. Deposit paid Yes / No Date: 9. Copy of IX Regn card received Yes / No *Copy of certificates should be attached

5 Application No. (NOT TO BE DETACHED) VIDYA ESTANCIA Estancia Township, GST Road, NH 45, Vallanchery PROVISIONAL ADMISSION CARD TO STD.XI Name of the Student... He/She is Provisionally admitted to Std. XI : Group He / She should produce the following within a week of the publication of the results in qualifying examination. 1. Original Mark Sheet 2. Original TC 3. Copy of Marksheet 4. Copy of CC 5. Copy of Pass Certificate 6. Copy of Migration Certificate 7. Fees receipt 8. Refundable Deposit receipt 9. Copy of IX Regn card Date: PRINCIPAL Application No. VIDYA ESTANCIA Estancia Township, GST Road, NH 45, Vallanchery Name of the Student : Date of Interview : INTIMATION CARD TO STD.XI (to be brought while attending the interview) To attend interview with his / her parent. If selected, fee is payable on The undersigned regrets inability to Admit the Applicant. Please bring both these cards on the above date. Date : PRINCIPAL (PTO for fees details) VIDYA ESTANCIA Estancia Township, GST Road, NH 45, Vallanchery Application No. REGISTRATION CARD (Student s Copy) Received from... an application for admission to XI Standard in Date :.. For PRINCIPAL

6 (Quote the above application Number in all future correspondence)