Online Preliminary Admission Form

Name of the Ward to be admitted in the school :

Date of Birth :

Mobile No.(Father/Mother/Guardian/Reference) :

Admission in Class : Admission in Class NURSERY

Blood Group : Blood group A+ A- B+ B- O+ O- AB+ AB-

2nd Language : Hindi Bengali

Name of the School attended ( if any ) :

Ward suffering from any ailment which requires any emergency treatment/urgent hospitalization :

Sister studying in St. Agnes' ( if any ) :

Class : Class LKG UKG I II III IV V VI VII VIII IX X XI XII

Name of the Father :

Address :

Mobile No. :

Qualification :

Religion : Religion African Traditional & Diasporic Agnostic Atheist Baha'i Buddhism Cao Dai Chinese traditional religion Christianity Hinduism Islam Jainism Juche Judaism Neo-Paganism Nonreligious Rastafarianism Secular Shinto Sikhism Spiritism Tenrikyo Unitarian-Universalism Zoroastrianism primal-indigenous Other

Community(e.g. Punjabi, Bengali etc.) :

Caste : Schedule Caste Schedule Tribe Others

Occupation (if service,specify designation with office address. If business, specify the business :

Income per month :

Name of the Mother :

Address :

Mobile No. :

Qualification :

Religion : Religion African Traditional & Diasporic Agnostic Atheist Baha'i Buddhism Cao Dai Chinese traditional religion Christianity Hinduism Islam Jainism Juche Judaism Neo-Paganism Nonreligious Rastafarianism Secular Shinto Sikhism Spiritism Tenrikyo Unitarian-Universalism Zoroastrianism primal-indigenous Other

Community(e.g. Punjabi, Bengali etc.) :

Caste : Schedule Caste Schedule Tribe Others

Occupation (if service,specify designation with office address. If business, specify the business :

Income per month :

Ex-student of this school : Yes No

State the details of marital status of the parents :

( To be filled up only if the parents are living separately on account of mutual separation/divorce/estrangement/temporary estrangement as on the date of application and if the couple are divorced and/or there is a pendency of any litigation then such details shall have to be disclosed at the time of making such application and if any of such litigation has reached a finality, then the photocopy of such order/decree is to be annexed and marked accordingly)

Name of the Guardian :

Address :

Mobile No. :

Qualification :

Religion : Religion African Traditional & Diasporic Agnostic Atheist Baha'i Buddhism Cao Dai Chinese traditional religion Christianity Hinduism Islam Jainism Juche Judaism Neo-Paganism Nonreligious Rastafarianism Secular Shinto Sikhism Spiritism Tenrikyo Unitarian-Universalism Zoroastrianism primal-indigenous Other

Community(e.g. Punjabi, Bengali etc.) :

Caste : Schedule Caste Schedule Tribe Others

DETAILS OF THE REFERENCE (Block Letters)
** All supportive documents are to be submitted with the application ( Xerox copies)

Please note that the name mentioned herein may be contacted to verify your statement made herein.

  N.B. : In case of any subsequent changes in any of the entries made herein, the same has to be communicated immediately, in writing in the prescribed format as sample of which is stated in this application form. Incomplete forms and lack of required documents will lead to automatic disqualification of the applicant.

I have read the contents of the prospectus and the current application form and upon submission of the duly filledin application form. I state that I have understood the meaning and purport of the rules and regulations as state therein and I declare to abide by and bound by them and accept them in its entirety.

All photo copies are to be stapled alongwith this current application form and it is to be marked as I, II, III,.. and so on. On each photo copy, the form number to be written.

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