i1 ~ flfl1rt, ~~ photograph (managed by dav.tatadavsijua.org/file/107/new admission form tata dav...
TRANSCRIPT
;:::~~=tftn:am~ifmr 1 ~~l)t~ ~ / anfWfq;rq;~ ]if ~ "Q\ fa';m' q;t I
I request that my Son/Daughter/ward be considered for Admission to Class in your School for the session........................................................................ ~~WU~-~"Q\~~mm/~Ptqq'fq)f'l1R'R~/~1 Shall
follow the rules/regulations of the school framed I issued from time to time. I
(racHUI/ PARTICULI).RS)
.••••..••••••(..,...~i/) 1................. 1..Name of Student (IN BLOCK LEITERS) .
DateofB~rth/~-ftlfu(lnfigUres/3icnT~. DtJ CCl ~Date of Birth 1iif.+T-ftfftT(ln words I~it) .
~"'iT11(~ 3l~it) ft!or 11TifT..................•............•.•............... ~.......•••••
Full Name (IN BLOCK LEITER) Father Mother .
~CfiT~ ~/~ct~~ .
SI. No.S:JDO .
SCHOOL STAMP
~if, ITa,~ / The Principal,
1.
2.
3.
4.
(I IOn Printed receipt only
«!II ~ '< ~ -~ -qf'a(1Cfi fClicri $'IH@ o:s a)-5r - 01D. A. V. PUBLIC SCHOPlS JHARKHNAD ZONE - 01
~lIH~ ~-~ ctiTJl\i1 ~ flfl1Rt, ~~ PHOTOGRAPH
(Managed by DAV. College Managing Committee, New Oeltii-55)
Ir-----~~~~~~~~~~----JI cnl4i{"t4 ~ ~ / For Office use II ~'{j. ~jq;
Regn. No..................... Date .
~Admitted in 1
~/Date .Adm. No .
I nmni.tReceipt No .
lI;f I Session 20 " I to 20 .
Guardian's Name Relation with the Student .
fQm Ill'lOT I ~CfiT~ 3W-qc: 1••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••
Father's I Mother's I Guardian's Occupation with Designation .
~~ / Monthly Income : v •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••
. I(a) ~I Correspondence Address , .
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(b) ~:I ~~:~~~~~t~~d~'~..............1..... =:': ·..··.· :..18. ~~. (3lTQT(f~it) ~(Cfif.) (an.) .
Contact No. (in case of emergency) Ph. (0) (R) : (.[
~·'a:;tr~· ..······58·0·0· ..··..······..~~·· · ····..·· ·..· ~ q;~ .
Acknowledgment Receipt SI. No Regn. No Date Class ; .
q;ffia;~ol/~ctf~tlp;mRrq;1"11n:ofcnm I Received an application for Registration IAdmission.
~Wt<fmr / Documents received
2. 3m:.R1:rnrmUT-mr(~/\OIRlrMfQ) Character Certificate (O/C.)
4.~-mW1M-~(~/SlRll{;tfCr) Birth Certificate (O/C.)
Of Municipal Corpn I Birth I Death Regn. Office
1. ~111'f1{OI1;lll1UT-W(1@"/ QRlR1fQ)Transfer Certificate (O/C.)
3. 3lq;;f<lIet~IUIa;1(~/!OIRlR1fQ) Marks Sheet (O/C.)
5. ~"\rI:rTOT-'Q;;r(~1 !OIRiI{;ti'Q)Medical Certificate (O/C.)
6. Copy of I. Card and Payslip of Father I Mother
working in BCCL or Subsidiary of C\ L\x1C<\&l:a\~q;'{~a,R
Sign. of Receiving Authority
9. ~fWl\U""fa<Rur I Particulars of previous studies :-: 1 1 .
(1) ~~I Name of the School .
(2) f~:;~:P:n~riftr~..~mm1"t&I't' I ClassLast attended/is studying .: .
(3) q;~~~~ I Promoted to Class .
~~ I Documents furnished:
(1) WHI4HOI m:tTUT-'Q3f(lJ?r/YRrfHfCI) . (a) Transfer Certificate (OriginaIlAttestedCopy) T..(2) ~w:nvr-q-;r(~/ SlRlR1f4) (b) Character Certificate (Original/Attested COpy) ] .
(3) 3lq; l'aa((lJjt.ti1 (~/YRrfHfq) (c) Marks Sheet (Original/Attested Copy) .
(4) ~'RIfWw:nvr-q-;r(~/SlRlR1fi:1) (d) Birth Certificate (Original/Attested COpy') 1 .
tcmrmqm~~~q;r~ I Whether Pl1IPii beiongs to SC/ST/BPL .
(1"'i11ldl Nationality ~Religion ~ .
10.
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1.
cOttOIlV DECLARATION
if~~~tfcf;~~~ ~'3?1'~/~ ~ ~t, itU ~1'1Cf1i~lif ~t 3fttif ~ ~~±~-fflfu~~ct~~~~1I here by declare that the particulars given in respect of my Son/Daughter/ward are true to the best of my knowledge and shallnot requestthe authorities for any alteration in date of birth etc. given above. Iif 'lI& ~ ~~ tftn mr '3?1'~/amwr m.m.~.l.~ WUfurlfto <iil1~ <iil175 ~ ctft ~ <t~r-qrwr~~1 .My ward will attend the class regularly and as per C'BSE norms he/she will fuifill the criteria of attendance i.e, 75% minimum.
2.
if 'lI& ~ ~~ tfcf; mr ~~/:mfWrmr<t~~ "\i'IRqn;fil['Qt trttamU if ~fat.Tm if nm~~Tfcn ~vrt<fCfi'{lrr~ I
My ward will pass subjectly as well as in aggregate in all the examinations held during the session.
4. ~ <:16R1t1IHlIiffcnm m'W-fiITCfital"i~lItltt"'ldl CfiT~CimlTt' Iqmft~~ttmift :ancmt'ctrffl~~m~ IHe or she, if found in any indisciplinary activity in th~ School his/her T.C. should be sent to my residence.
3. . if
5. if~~~CfiT~qITfqffit~~if~<iiT~~ I
I shall not request for any change in the child's particulars at any stage.
~/Date:mor!fi«:rr/~ (~T~)
Full Signature of Mother/Father/Guardi n
Certified that Shri/Smt. Father! Mother of .
Class is a regular employee of the Company I Organisation I Project I Colliery under area .
Personnel No and is entitled to fee payable atthe rate chargeable from t~e wards of company employees.
Area Personnel Manager I GMSigh. with Seal
( FOR OFFICE USIE : ADMITTED TO )Class Section on r .•.......•........•.............•........ Scholar's Regn. No 1•••
Clerk Principal
NOTE ;-
1.2.3.
Must give an undertaking for payment of fee.The student must maintain good conduct in the school.
That I have read all the terms & conditions prescribed
by the school and agree to abide by it.
Sign. of Parent I Guardian