P-615, Block – “O”, New Alipore, Kolkata-700 053 Tel: 82760 85307, e-mail: sree.ashm@gmail.com

H.S.CODE: 01369

SREE SARADA ASHRAMA UCHCHA BALIKA BIDYALAYAHIGHER SECONDARY SECTION

Ref. No. .............................

Form No. .............................

Date .............................

ADMISSION FORM FOR CLASS – XI

Session 20….... - 20…....

Affix Passport size

PHOTO

(self attested)

1. Name (in Block Letters) …………………………………………………………………………...............

2. Date of Birth ……………………………………………………………………………...............................

3. Religion ……………………………………… Mother Tongue ……………..............................................

4. Nationality …………………………………… Caste/Tribe ……………...................................................

5. Name of Father ……………………………………………………………………………..........................

6. Name of Mother …………………………………………………………………………….........................

7. Name of Guardian ……………………………………………………………………………......................(in case of Father/Mother is not the guardian)

8. Permanent Address ……………………………………………………………………………....................

9. Present Address …………………………………………………………………………….........................

10. Passed Secondary Examination of Board ……………………………………………………....................

11. School Attended (since Class-V) …………………………………………………….................................

12. Marks obtained in Madhyamik Pariksha (M.P.) or equivalent examination, 20 ………………...................

M. P. Roll ……….............……. No. ……….............……. Year ……….............…….

SUBJECT MARKS SUBJECT MARKS

1. 1st Language

2. 2nd Language

3. Mathematics

4. Physical Science

5. Life Science

………........

………........

………........

………........

………........

6. History

7. Geography

8. Total

9. Total Percentage

10. Additional Subject

………........

………........

………........

………........

………........

(excluding addl.)

(if any)

Occupation ……………………………………………………………………………................................

Occupation ……………………………………………………………………………................................

Contact no …………………………………………… Whats App No……………………………….........

Contact no ……………………………………………………………………………................................

(or equivalent)

COMMERCE

CHOSEN SUBJECTS

1. ……………………………................................................

2. ……………………………................................................

3. ……………………………................................................

4. ……………………………................................................

14. Extra Curricular Activities (if any): …………………………………………………..............................…....

15. I, the undersigned do hereby declare that I will always abide by the Rules and Regulations of the

Institution and will maintain at least 80% class Attendance .

Date .............................……................................................

Signature of the Candidate

16. The above declaration is correct in regard of my ward, ………………...............................………………

for her admission. I agree to pay all dues in time and take proper care about my ward's studies and

general conduct.

Date ............................. ……................................................

Signature of the Guardian

Note: 1. Original Marksheet & Admit Card to be produced at the time of Admission.

2. Attested copies of Admit Card, Marksheet, character & caste certificate, migration certificate to be submitted along with the application.

(FOR OFFICE USE ONLY)

Verified by (signature): ……………………………………….......................................................................……

Date of Admission: ……..................………. Class: ……..................………. Stream: ……..................……….

Remarks (if any):

Principal

……................................................Date .............................

13. COMMERCE STREAM

1. Accountancy – Business Studies – Costing and Taxation – Computer Application

2. Accountancy – Costing and Taxation – Mathematics – Computer Application

FIRST LANGUAGE - BENGALI, SECOND LANGUAGE - ENGLISH

FOR FUTURE SUBMISSION