Gondwana sainiki vidyalaya & uchcha
madhyamik vidyalaya, Gadchiroli
Chamorshi Road, Navegaon, Po-Yeoli Ta + Dist – Gadchiroli, 442 605.
Contact No. Office-9823739488, HM-9404126627, AHM-9405510001
For Office Use Only
Form No…………….. D.O.Form Submission……………………………. Roll No……………….
Mentaly – Fit / Unfit, Physically – Fit / Unfit, Medical – Fit / Unfit
ADMITTED / REJECTED to Std………….. Reg. No…………. D.O.Admission……………………………..
Date -……………………………. Clerk HM/Principal
Note- Incomplete form will not be accepted
Application for Admission to Std - …………. & Hostel
1) Student’s Full Name :- …………………………………………………………………………….………
(In English Capital Letters) ……………………………………………………………………...……
Aadhar No.
2) Date Of Birth
In Word :- ………………………………………………………………………………………………….
3) Place Of Birth :- At- …………………………………………... Po - ……………………….……………
Tah- ……………………………………………Dist-……………………………………
4) Identification Mark :-………………………………………………………………………………………
5) Mother Tongue :-……………………………… 6) Caste/Subcaste -……………………………..
7. ) Category (ST/SC/VJ/NT-B,C,D/SBC/OBC/Open) - ………………………8) Religion - ……..……………………………
9) Domicile – MAHARASHTRA 10) Nationality – INDIAN
11) Last School Studied/Studying -…………………………………………………………………………….
(Name & Address) …………………………………………………………………………......
12) School U-DISE Code -
13) Student ID –
14) Std. Studied Last……………….Medium-……………………. Percentage………………….Grade………….
15) Postal Address (Temporary):-……………………………………………………………………………….....
………………………………………………………………………………………………………………………..
16) Postal Address (Permanent) :- ……………………………………………………………………………………
………………………………………………………………………………………………………………………...
17) Contact Nos. ………………………………………………………………………………………………………
20) Habits, Hobbies, Talents, Temperaments etc- ………………………………………………………………………
…………………………………………………………………………………………………………………………
21) Father’s Guardian’s Full Name :- Shri………………………………………………………………………………
Occupation/Designation :- ……………………………………Annual Income……………………….……………
Office Name :- ………………………………………………………………………………………………………..
Office Address :- ………………………………………………………………………………………………………
Office / Firm Coantact No :- …………………………………………………………………………………………
22) Mother’s Full Name :- Sau./Smt…………………………………………………………………………………….
Occupation/Designation :- ……………………………………Annual Income……………………….……………
Office Name :- ………………………………………………………………………………………………………..
Office Address :- ………………………………………………………………………………………………………
Office / Firm Coantact No :- …………………………………………………………………………………………
23) Annual Total Family Income :- …………………………………………………………………………………….
24) Name of Brothers / Sisters :- ………………………………………………………………………………………
(With Class Studying) ………………………………………………………………………………………..
25) Local person in relation or friend to whom boy may meet or contact in emergency.
Name :- ………………………………………………………………………………………………………………….
Address :- …………………………………………………………………………………………………………………
Contact No :- ……………………………………………………………………………………………………………..
declaration
1. I read the prospectus carefully. I am willing to admit my son / ward in Gondwana Sainiki Vidyalaya & UMV,
Gadchiroli. I give consent and I will have no claims on the authorities for any compensation. I shall not hold
any one responsible if my son / ward leaves the school without written permition of Principal /Vice Principal
/Supervisor/Warden. I shall regularly pay the school, Hostel and Other fees in advance and pay all the incidental
/Tour / Camp / CD/Photo charges expenses at the school before prescribed date.
2. I hereby declare that all the information given in this application is true, complete and correct to the best of my
knowledge & belief. I have read the rules and conditions given in yhe GSV prospectus carefully and I hereby
undertake to abide by them.
Date :- Sign Sign
Student Parent/Guardian
Name……………………………… Name……………………………….
Attached Documents for form Submission
1. Aadhaar Card Xerox -1
2. Passport Size Photo(Current) -2
Attached Documents for Admission
1. Aadhaar Card Xerox -1
2. Passport size Photo (Current) -4
3. Transfer Certificate Original & Xerox -2
4. Marksheet Original & Xerox -2
5. Sanchayi Pustika Original -1 -
6. Stamp Papers 20rs or Above -1
7. Caste Certificate/Validity only ST Student -1
8. Student Bank Passbook xerox if Available -1
Gondwana sainiki vidyalaya & uchcha
madhyamik vidyalaya, Gadchiroli
Chamorshi Road, Navegaon, Po-Yeoli Ta + Dist – Gadchiroli, 442 605.
Contact No. Office-9823739488, HM-9404126627, AHM-9405510001
ENTRANCE TEST IDENTITY CARD (Keep With Candidate)
Application Form No…………….. Roll No……………………
Admission to Std…………………. Medium of Entrance : Marathi/English
Full Name :-…………………………….………….…………………………………………………………….
Category……………..Date of Birth :…………………………….
Date of Entrance : Written & Dictation-Saturday…………………………. From 10.30am Sharp.
Written & Dictation Result on Same Day at 3.00pm.
If passed physical,Medical, Measurements & Interview on Following Sunday From 8.00am
(Wear Sport Shoes & Comfortable Dress & Inner. No Jeans)
Final Result on Coming Friday From 11.00am
Contact No.- 9405522143, 9423423313 (Clerk)
Gondwana sainiki vidyalaya & uchcha
madhyamik vidyalaya, Gadchiroli
Chamorshi Road, Navegaon, Po-Yeoli Ta + Dist – Gadchiroli, 442 605.
Contact No. Office-9823739488, HM-9404126627, AHM-9405510001
ENTRANCE TEST IDENTITY CARD (Keep With Candidate)
Application Form No…………….. Roll No……………………
Admission to Std…………………. Medium of Entrance : Marathi/English
Full Name :-…………………………….………….…………………………………………………………….
Category……………..Date of Birth :…………………………….
Date of Entrance : Written & Dictation-Saturday…………………………. From 10.30am Sharp.
Written & Dictation Result on Same Day at 3.00pm.
If passed physical,Medical, Measurements & Interview on Following Sunday From 8.00am
(Wear Sport Shoes & Comfortable Dress & Inner. No Jeans)
Final Result on Coming Friday From 11.00am
Candidate have appeared for the following Tests:
Exam Remark Sign of Conductor
1) Written - ………………………………. ……………………………….
2) Dictation - ……………………….……… ……………………………….
3) Running(200M) - ……………Min…………Sec ……………………………….
4) Long Jump(Longest) - ……………Mtr…….……Cm ……………………………….
5) Body Measurment - Ht, Wt, Chest, Waist, L/Shoes, Track Suit No ……………………………….
6) Uniform Measurment- Shirt, Pant ……………………………….
7) Interview Oral - ………………………………… ………………………………
8) Medical - Flat Feet. Knock,General, Dental,Eye,ENT ………………………………
9) Pathology - Blood Group, Sickle Cell ………………………………
10) ………………….. -………………………………….. ………………………………
Candidate have appeared for the following Tests:
Exam Remark Sign of Conductor
1) Written - ………………………………. ……………………………….
2) Dictation - ……………………….……… ……………………………….
3) Running(200M) - ……………Min…………Sec ……………………………….
4) Long Jump(Longest) - ……………Mtr…….……Cm ……………………………….
5) Body Measurment - Ht, Wt, Chest, Waist, L/Shoes, Track Suit No ……………………………….
6) Uniform Measurment- Shirt, Pant ……………………………….
7) Interview Oral - ………………………………… ………………………………
8) Medical - Flat Feet. Knock,General, Dental,Eye,ENT ………………………………
9) Pathology - Blood Group, Sickle Cell ………………………………
10) ………………….. -………………………………….. ………………………………
