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Admission Form 2016-17

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Mitan Debnath
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140 views2 pages

Admission Form 2016-17

Uploaded by

Mitan Debnath
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Online form
OXFORD PUBLIC SCHOOL
Affiliated to C.B.S.E. Delhi, Affiliation No. 3430121
PRAGATI PATH, RANCHI, JHARKHAND - 834 011, PHONE: 0651-6450349
APPLICATION FOR ADMISSION
(Admission depends on merit and availability of seats)

Principal's Order : (For Office Use Only) Signature of Admission


Incharge :
Passport size
Receipt No. ……………………….…….. Date …………………………. Photograph
to be pasted
Admission No. ………………………….. Date ………………………….

Bus Stop ………………………………. Bus No. ………………………

For Class : …………..


1. Name of Applicant (in Block letters) :

First Name Middle Name Surname


2. Date of Birth :
(In words : …………………………………………………....…………………)
Date Month Year
3. Sex (M/F) : …………..…… 4. Category (ST/SC/OBC-Enclose Caste Certificate): …………………..……
5. Child with Special Needs (Enclose medical certificate in case of specially abled) : No Yes
6. Father's Name :

7. Mother's Name :

8. Please fill the following information : MOTHER FATHER

Academic Qualification : ……………………………………… ………………………………….………….

Designation : ……………………………………… ………………………………….………….

Occupation : ……………………………………… ………………………………….………….

9. Nationality of the Child …………………………………………………...... 10. Religion ...………….…………

11. Permanent Address: …………………………………………………………………………………………………

………………………………………………………………………………….… PIN ……………………………

12. Mailing Address: ………………………………………………………………………………………….……...…

………………………………………………………………….………………… PIN ……………………………

13. Telephone Number: Residence …..………………… Office ………...…….…… Mobile: …….………..…...……



ACKNOWLEDGEMENT

Application No. ………………………………… For class ……………………………….


Signature of the
Date of Test ……………………………………… Time …................................................. Receiving Assistant
[2]

14. Particulars of previous studies:


a) Name & Address of School ……………………………………………… b) Affiliated to ……………….…
c) Medium of instruction …………………. d) Class last attended ………….. e) Year of study ……………

15. Documents to be Furnished :


* Class Prep & I, either the original Date of Birth from the Municipality or the Transfer Certificate
(T.C.) from the previous school must be submitted at the time of admission. For class II onwards
original T.C. is required.

16. Brothers & Sisters studying in this School (Name, Class and Admission. No.)
a.
………………………………………………………………………………………………………………………
b.
………………………………………………………………………………………………………………………

DECLARATION
I hereby declare that the particulars furnished in respect of my son/daughter/ward are true to the best
of my knowledge. If any information or declaration given by me, proves to be false, the candidature of my
son/daughter/ward may be cancelled at any stage.

Fees once paid is non-refundable under any circumstances.


All disputes are subject to Ranchi Jurisdiction.

Signature of Applicant with Date Signature of Parent/Guardian with Date

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