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RAJAGIRI HIGHER SECONDARY SCHOOL
RAJAGIRI P.O., KALAMASSERY - 683 104
FORM 3 [See Rule V1-1(1)]
Application for Admission(Class 1 to 10)
(Fields marked with
*
are mandatory)
1.
Name of Pupil(
in capital letters
)
*
.
2.
Name of Pupil in Regional Language
3.
Sex
*
Male
Female
4.
Name of Father
*
5.
Name of Mother
*
6.
Occupation of Father /Mother
Permanent Address
7.
House Name
*
8.
Locality
*
9.
Post Office
*
10.
District
11.
Pincode
12.
Phone No.
*
13.
Mobile
*
14.
Email
15.
Whether boarding facilities for boys required
*
Yes
No
16.
Name of Guardian(
if father or mother not alive
)
17.
Name and address with Phone No. of the Local Guardian(
in case the pupil does not live with his responsible guardian
)
18.
Schools previously attended with time in each
Name of School
standard
Date of Admission
Date of Leaving
19.
Date of Birth
*
20.
Whether certified extract from the Register of births and/or TC has been produced
*
Yes
No
21.
Age as on 1st June of the year of admission
*
22.
Religion
*
23.
Caste
*
24.
Place of Birth(as given in the Birth Certificate)
*
25.
Nationality and state to which the pupil belongs
*
26.
Name of Panchayat/Muncipality/Corporation to which the pupil belongs
*
27.
Does the pupil belong to SC/ST/OEC/OBC/General
*
28.
Standard to which admission is sought(in words)
29.
Mother-toungue of pupil
30.
No.and date of Transfer Certificate produced on admission
31.
DD No
*
32.
DD Date
*
33.
Bank Name
*
34.
Photo
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