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This document contains an application form for admission to Ram Ratna Vidya Mandir school. It requests information about the student such as personal details, family details, previous schooling records, medical conditions, and hobbies. It also provides instructions for submitting documents along with the application such as birth certificate, school leaving certificate, health records, and caste certificate if applicable. The form is to be signed by the parent and local guardian who must submit an undertaking agreeing to abide by the school's rules and regulations.

Uploaded by

Ankur Choudhary
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© Attribution Non-Commercial (BY-NC)
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Download as PDF, TXT or read online on Scribd
20 views

Ad Mi Form

This document contains an application form for admission to Ram Ratna Vidya Mandir school. It requests information about the student such as personal details, family details, previous schooling records, medical conditions, and hobbies. It also provides instructions for submitting documents along with the application such as birth certificate, school leaving certificate, health records, and caste certificate if applicable. The form is to be signed by the parent and local guardian who must submit an undertaking agreeing to abide by the school's rules and regulations.

Uploaded by

Ankur Choudhary
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 3

UTTAN VIVIDH LAKSHYI SHIKSHAN SANSTHAS

RAM RATNA VIDYA MANDIR


ISO 9001:2000 CERTIFIED SCHOOL

CBSE AFFILIATION NO. 1130044

Keshav Srushti, Uttan, Bhayander (W), Thane: 401106. Tel.: 0091-22-28450707/0718, Fax: 0091-22-28450500

Website: www.ramratnavidyamandir.org Email: [email protected]


HTU

UTH

HTU

UTH

APPLICATION FOR ADMISSION


PHOTO

STUDENTS DETAIL
U

Sr. No.
Standard in which Admission is sought
Please tick (

Name in Full
In Block Letters

) whether : Indian Citizen (


____________________
Last

) Non Indian Citizen (

__________________________
First

_________________________
Middle

Date of Birth

________
________
____________
Year
Month
Day
Birth Place : Town/Village
State
Country
Caste / Religion
Whether a Member of a Scheduled Caste or a Tribe or A community Classified as Backward Class or Tribe by
the State Government
If the Answer is yes, submit documentary proof
Languages
(a) Spoken at home
(b) Medium of Education for previous Schooling
Personal Details : (a) Height
cms. (b) Weight
Kgs.
Special interests in hobbies, games, music or other extra curricular activities. Please specify*
Past illness if any ? Pl. give history*
Does the child have any identified allergies ? If so, give details*
Any Physical / Mental handicaps : Please describe how it affects the childs behaviour and functioning*

Record of previous education : Please start with the last school.


U

Sr.
No.

Name of the School

Board
State / CBSE / ICSE/
International

Year

Std
Passed

% of Marks/
Grade

Prizes or awards won either for scholastic achievement or activity ? If yes, give details*
Was the child any time removed from any school for disciplinary or academic reasons ?
Please tick (

) Yes (

) / No (

) If yes, give details*

Use separate sheets if required.


Format No.: ADM/FM/04

Rev.01

Page 1 of 3

PARENTS DETAIL
U

FATHER
U

MOTHER

Name

___________________________________

____________________________________

Date of Birth

___________________________________

____________________________________

Blood Group

___________________________________

____________________________________

Education

___________________________________

____________________________________

Occupation

___________________________________

___________________________________

(If Business, nature?)

___________________________________

___________________________________

Anniversary Date

___________________________________

Annual Income

___________________________________

Email ID (Essential)

___________________________________

How many Brothers & Sisters to the students :


Name
Date of Birth
U

Education

Residential Address
U

Description

Local Guardian Address


U

_____________________________________________

_____________________________________________

_____________________________________________

_____________________________________________

_______________________Pin Code ______________

______________________Pin Code _______________

Tel. No. (Resi)

______________________________

Tel. No. (Resi)

_______________________________

Tel. No. (Off)

______________________________

Tel. No. (Off)

_______________________________

Mobile No.

______________________________

Mobile No.

_______________________________

Fax No.

______________________________

Fax No.

_______________________________

Email ID

_______________________________

Email ID(Essential) ______________________________

I certify that the information furnished above is complete and correct to the best of my knowledge.
Signature

Name (in capital letters)


Relationship with the child
IMPORTANT NOTE
U

An application for Entrance Test must be accompanied by :


1.
A demand draft for Rs.3000/- or $ 75 payable to Ram Ratna Vidya Mandir
2.
Birth Certificate (Xerox Copy)
3.
Previous Marksheet. (Xerox Copy of latest report)
To be submitted at the time of admission :
1.
School Leaving Certificate from the school last attended.
2.
Health record from Family Doctor to be submitted at the time of admission.
3.
Four copies of recent passport size photograph of the child + 20 additional copies to be kept with the child.
4.
Xerox Copy of Caste Certificate, if applicable.

*Use separate sheet if required.


Format No.: ADM/FM/04

Rev.01

Page 2 of 3

ANNEXURE A
UNDERTAKING BY LOCAL GUARDIAN
solemnly declare

Shri/Smt.

That I have read the rules and regulations of Ram Ratna Vidya Mandir and assure you that I shall abide by
them as local guardian of the student (Name of the student)

Signature
Date

Place

Full Name
Relationship with the student

-------------------------------------------------------------------------------------------------------------------------------------------------------------

FOR OFFICE USE ONLY


Students General Registration (GR) No. .
Particulars

Receipt No.

Date

Amount

Admission Form Fee


Entrance Test Fee
Admission Fee
Total
------------------------------------------------------------------------------------------------------------------------------------------------------------ADMISSION CARD
Regd. No.
To be filled by the Parents :
Full Name
Fathers Name

PHOTO
Mothers Name

Address
Admitted to Std.

PRINCIPAL
RAM RATNA VIDYA MANDIR
Madhav Vidya Niketan Sankul
Keshav Srushti, Uttan, Bhayander (west),
Dist: Thane 401 106, Maharashtra

Format No.: ADM/FM/04

Rev.01

Page 3 of 3

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