APPLICATION FOR ADMISSION TO XI-XII
NAME
DOB
Personal Mark Identification1
Personal Mark Identification2
Gender
Select
Male
Female
Nationality and state to which the pupl belongs
Religion (this information is intended only for statistical purpose)
Select
Hindu
Christian
Muslim
COMMUNITY
BC
OBC
FC
SC/ST
CASTE
FATHER'S NAME
MOTHER'S NAME
OCCUPATION(FATHER)
ADDRESS
NAME OF THE GUARDIAN
OCCUPATION
ADDRESS
Qualifying Examination Passed
QUALIFYING EXAMINATION PASSED StateBoard/CBSE
Examination Passed
Month & Year
SUBJECT
MAXIMUM MARKS PRESCRIBED
MARKS OBTAINED
PERCENTAGE
CLASS LAST STUDIED
TC ATTACHED
Select
Yes
No
MOTHER TONGUE
Medium in which the pupil studied at the time of the leaving the school
State whether admission is sought for the first year or second year of the course
Medium of instruction desired at the Higher Secondary stage
Subject Offered
Select
Tamil
English
IF NAME & LOCATION (DISTRICT) OF SCHOOL LAST STUDIED
DAY STUDENT/HOSTEL ANDAMAN NICOBAR ISLANDS?
DAY
HOSTEL
OTHER STATE
Yes
No
SINGLE GIRL CHILD
Yes
No
IF REFERENCE DETAILS
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GROUP III ACADEMIC TERM
First
Second
Third
Fourth
Medium
Choice
Whether protected from small pox? Vaccinated or small pox marked?
Select
Yes
No
Proficiency in Extra-curicular activities (attested copies of the certificates to be atfached)
Select
Yes
No
Is the candidate wiling to join Scouts and Guides/Red Cross /NSS ?
Communitcation Address With Pincode
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