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A Unique School Based on Indian Cultural Heritage and a Global
Vision
(ICSE Affiliation No. MA126)
Jain Divine Park, Shirsoli Road, P. O. Box 115, Jalgaon - 425
001 - Maharashtra,Tel.: 0257-2264600, Mob.: 9422776726. Fax :
0257-2264913, E-mail : [email protected], Visit us at :
www.anubhutischool.in
APPLICATION FORM for CLASS 11 (ISC) 2018-19
Please read the following notes carefully before filling the
Form.
Form should be filled completely by the parents, no blank fields
should be left in the form.
The details - (such as Date of birth, spellings of all Name,
Surname, Caste etc.) should match
with students previous school leaving certificate (LC / TC) and
other documents. The details
as per previous school LC/TC will be considered as final.
Attach a xerox of the latest mark sheet / progress report and
Aadhar Card
Attach a DD of Rs.1500/- in favour of Anubhuti School.
Submit the documents for the information filled in this
application form, if asked.
Name of student:
________________________________________________________________
First Name Fathers Name Surname
Mother tongue: ___________________ Gender: Boy Girl
Does the student possess Aadhar Card? : Yes No
If yes, Students Aadhar Card No.:
Student Birth Details:
Date of birth:
D D M M Y Y Y Y
Birth Place (Village/City): ______________ Taluka (Tehsil):
____________ District: ____________
State: ______________________ Country: ________________
Religion (): ___________ Caste (): _______________ Sub-caste
(-): __________ Category (): (for eg.: OBC/SC/ST/General)
______________________ Nationality: ________ For eg. 1) Religion
Hindu, Caste Maratha, Subcaste -Kunbi, Category General/SC/ST/OBC
etc.
2) Religion Jain, Caste Marwadi, Subcaste Agrawal/Maheshwari,
Category General
Recent color
photograph of
the Child
Recent color
photograph of
the Father
Recent color
photograph of
the Mother
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Familiarity with Languages:
No. Languages Known Read
(Tick )
Write
(Tick )
Speak
(Tick )
1.
2.
3.
4.
Details of previous school:
Name of the School:
_____________________________________________________________
City: ________________________________________ State:
____________________________
U-DISE No. of School:
____________________________________________________________
Board: (State/ CBSE/ ICSE/ IGCSE) ________________ Medium of
Instruction: ______________
Present Class: ________ Result Status: Pass / Fail / Awaited;
Marks (%): ______________
Reason for Leaving School:
________________________________________________________
Academic Achievements:
_________________________________________________________
Non-academic Achievements:
_____________________________________________________
Subject combination for Class 11
English is compulsory and choose any four elective subjects (See
Annexure for guidelines)
First preference : 1)________________ 2) _______________ 3)
_______________ 4) ______________
Second preference: 1)________________ 2) _______________ 3)
_______________ 4) ______________
Third preference : 1)________________ 2) _______________ 3)
_______________4) ______________
Reasons for choosing Anubhuti School for your child:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Family Details:
Is the student an adopted child? Yes No
If yes, who is financially responsible for the child?
____________________________________
Student is living with: Both Parents Mother Father Guardian
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Fathers Details:
Full Name
Educational Qualifications
Residential Address
(With City, Tehsil, District, State)
(Pin Code)
Postal Address for Correspondence
(With City, Tehsil, District, State)
(Pin Code)
Contact Nos. (Mobile)
Contact Nos. (Landline)
Fax No.
E-mail Address
PAN Card No.
Occupation (Service / Business)
Name of Employer / Type of Business
Mothers Details:
Full Name
Educational Qualifications
Residential Address
(With City, Tehsil, District, State)
(Pin Code)
Postal Address for Correspondence
(With City, Tehsil, District, State)
(Pin Code)
Contact Nos. (Mobile)
Contact Nos. (Landline)
Fax No.
E-mail Address
PAN Card No.
Occupation (Service / Business)
Name of Employer / Type of Business
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Guardians Details (only If applicable):
Full Name
Educational Qualifications
Residential Address
(With City, Tehsil, District, State)
(Pin Code)
Postal Address for Correspondence
(With City, Tehsil, District, State)
(Pin Code)
Contact Nos. (Mobile)
Contact Nos. (Landline)
Fax No.
E-mail Address
PAN Card No.
Occupation (Service / Business)
Name of Employer / Type of Business
Details of real brothers and sisters of the student:
Name Age Class Name of School presently studying in
Emergency Contact details:
Name: _________________________ Place: ___________ Relationship
with student: ________
Mobile/Tel. No.:_________________________________ Email:
__________________________
Has your child appeared for admission test at Anubhuti earlier?
Yes No
If yes, when? (Month and Year) _____________________ for which
Class? ______________
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Kindly answer the following questions either in English or Hindi
or Marathi.
Please provide a brief description of the child by mentioning
his/her aptitudes, temperament and
behavior. (His / Her likes, dislikes, relationship with others
etc.) ?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Mention his/her strengths and weaknesses ( , ,
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
What are the areas your child needs to improve? (e.g.
Punctuality, Time Management, Personal
Care etc.) - #$ ' ( ? ( , * *)
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
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What specific difficulties does your child have in the process
of learning? - - / / 2 ?
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Health:
Does your child have any vision problem? Yes No
If yes, describe:
___________________________________________________________________
Does your child have any hearing problem? Yes No
If yes, describe:
___________________________________________________________________
List any operations, serious illnesses, injuries (especially
head), hospitalizations, allergies, or other
medical conditions your child has had. '
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Did your child go through any previous psychological,
psychiatric or neurological tests? If so, by
whom, when, and what was your understanding of their findings? '
, *
______________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
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Describe your childs regular diet. Do you have any concerns
about your childs eating habits?
(eg. Over-eating or not eating as per need or likes junk food
etc.) ' / (- ( : $ , ; ? *)
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Are there any concerns about your childs sleeping habits? Yes
No
If yes, kindly describe, @ ' A ,
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
In which areas do you feel, Anubhuti School will help in
development of your child ?
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
How does your child follow instructions, advice and other
matters of discipline at home and school?
A ' : , D?
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Where did you hear about Anubhuti School?
Google Newspaper Parent reference Jain Group Associates
Alumni Seminars School Website Other (Please
Specify):_________________
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Declaration
We hereby certify that all the information provided by us is
correct and we understand that
if the information is found to be incorrect or false, our ward
shall be automatically debarred
from the selection / admission process without any
correspondence in this regard.
We accept the process of admission undertaken by the school and
we will abide by the
decision taken by the school authorities.
We understand that Application Form Fees is non-refundable.
We understand that Application / Registration Process carries no
guarantee of admission, so
in this process, we will never ask for any privileges for our
child.
We understand that we will be providing necessary documents as
and when asked by school
as a part of Government Education Department policy
compliances.
We have understood the contents mentioned above and accept them
unconditionally.
: E D
Signature (Father): ________________________ Signature (Mother):
_____________________
Signature (Guardian), only if applicable:
___________________
Place: ___________ Date: ________________
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Parents copy
An ICSE/ISC coeducational residential School based in Jalgaon,
Maharashtra
ISC [Class-11] 2018-19
WIDE RANGE OF SUBJECT CHOICES
A minimum of 5 subjects
(English + 4 subjects) should be chosen.
Compulsory Subject
English
Elective subjects
Choose any four subjects from following subjects
Physics
Chemistry
Biology
Mathematics
Biotechnology
Accounts
Commerce
Economics
Business Studies
Psychology
Art
Physical Education
Indian Music (Hindustani)
Computer Science
Anubhuti School, Jalgaon
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Jain Divine Park, Shirsoli Road, P. O. Box 115, Jalgaon - 425
001 (MS). Tel : 0257-2264600, 2264903,
Fax : 0257-2264913, E-mail : [email protected] , Visit us
at : www.anubhutischool.in
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Page 11 of 12
Parents copy
A unique school based on Indian Cultural heritage and a global
vision
(ICSE Affiliation No.MA126)
SCHOOL FEE STRUCTURE 2018 - 2019
Particulars
Indian
Resident
(Rs.) /
Non-Residential Indians /
Foreign country citizens
(in Hong-kong Dollars)
HK$
Non-Recurring (One Time)
Application Form (Payable at the time of
application) Rs. 1,500/- 214/-
Admission Fees (At the time of Admission;
Non-refundable) Rs. 15,000/- 2,136/-
Interest Free Caution Deposit Amount
(At the time of Admission; Refundable) Rs. 1,00,000/-
14,241/-
Recurring Per Year (Figures to be revised annually)
Grade 5 Grade 10 Annual Fees for Boys Rs. 2,65,000/-
37,735/-
Grade 5 Grade 10 Annual Fees for Girls
(Special Discount for Girls) Rs. 2,50,000/- 35,599/-
Grade 11 - Annual Fees for Boys
Commerce Rs. 2,65,000/- 37,735/-
Grade 11 - Annual Fees for Girls
Commerce Rs. 2,50,000/- 35,599/-
Grade 11, Grade 12Annual Fees for Boys
Science Rs. 2,85,000/- 40,584/-
Grade 11, Grade 12Annual Fees for Girls
Science Rs. 2,70,000/- 38,448/-
Boarders Personal Account Deposit Rs. 20,000/- 2848/-
Excursion Fees Rs. 20,000/- 2848/-
Rules regarding Payment of Fees by Fresh Admissions
Students:
Total school Fees payment (Non-refundable) + Interest Free
Caution Deposit Rs. 1,00,000/-
(Refundable) along with submission of necessary documents,
undertakings, affidavits need to be
done within 10 days after receiving school communication about
confirmation of Admission,
failure to which admission will be offered to any other
child.
For Non-residential Indians / Foreign citizens, above said
amount need to pay within 18 days after
receiving school communication about confirmation of Admission,
failure to which admission will
be offered to any other child.
P.T.O
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Page 12 of 12
Foreign nationals or NRIs may pay in Indian currency as per
prevailing exchange rate. Boarders
personal account will be maintained in Indian Rupees and any
refunds will be made only in Indian
Rupees.
In case of a change in the status of a parent from NRI or
foreign national to resident and vice
versa, the change of fees will be applicable only from the
beginning of the next academic session.
For those who are applying for scholarships, reduction in waived
off amount is part of last
installment.
Note: Text books, educational material, stationery items, sports
gear, tuck shop purchase, minor
medical expenses, laundry, local treks, bed mattress etc. will
be supplied by the school
and charged extra and debited to the Boarder's Personal Account
separately.
Mode of Payment:
Online payment can be done to Anubhuti School by filling
following Bank Details only:
Organization Name : Anubhuti School
Bank Name : State Bank of India
Account No. : 30172732660
Branch Details : Dana Bazar Branch
IFSC Code : SBIN0007570
Ultimate beneficiary : Anubhuti School, Post Box No. 115,
Shirsoli Road, Jain Divine Park,
Jalgaon 425 001, Maharashtra, India.
It is mandatory to send Online Money Transfer / Online Payment
receipt by mail to
[email protected] once online payment is done.
Mentioning Student Full Name & Class in subject of E-mail /
on payment advice, is mandatory.
Cheque/ DD Payment:
At Par Cheque / DD can be drawn by favoring Anubhuti School and
can be mailed to Address
as given below:
Address:
Anubhuti School
Post Box No. 115,
Shirsoli Road, Jain Divine Park,
Jalgaon 425 001, Maharashtra, India.
Tel.: 0257-2264600.
Note: No cash will be accepted in any circumstances for any sort
of fees payment transactions.
