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Application2023-05-24 08 - 39 - 49 - 230524 - 084316

This document contains an application for admission to Mar Gregorios Memorial Senior Secondary School for the 2022-23 year. It includes details about the student, Arpit, such as personal information, family details, address, marks obtained in Class 9, and document uploads. It also contains declarations signed by the student and parent agreeing to follow school rules. Upon approval, it will provide admission details like class, group, and house assigned.

Uploaded by

Ujjwal Ekka
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© © All Rights Reserved
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56 views4 pages

Application2023-05-24 08 - 39 - 49 - 230524 - 084316

This document contains an application for admission to Mar Gregorios Memorial Senior Secondary School for the 2022-23 year. It includes details about the student, Arpit, such as personal information, family details, address, marks obtained in Class 9, and document uploads. It also contains declarations signed by the student and parent agreeing to follow school rules. Upon approval, it will provide admission details like class, group, and house assigned.

Uploaded by

Ujjwal Ekka
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Mar Gregorios Memorial Senior Secondary School

SECTOR - VI, BHILAI (CHHATTISGARH)


(An English Medium School affiliated to C.B.S.E.)
Phone: (0788) 228-4646, 228-3849, Email address: mgmsssbhilai@gmail.com

APPLICATION FOR ADMISSION - YEAR: 2022-23

Application No : MGM/274/2023-2024

PARTICULARS OF THE CANDIDATE

1 . Name of the Candidate (in block letters) (As


per the SSC Certificate) : Arpit
2 . Class : XI
3 . Date of Birth (As per the SSC Certificate) : 01-12-2005
4 . Gender : Male
5 . Communication Mobile No : 7470983883
6 . Religion : Christian
7 . Caste : st
8 . Mother Tongue : hindi
9 . Communication Email Id : arpitekka8@gmail.com
10 . Aadhar Eid/Uid Number : 361504557084
11 . Age (as on 31st March 2023) : 17

FATHER'S DETAILS

1 . Name of Father's (in full) (As per the SSC


Certificate) : Bhushan Ekka
2 . Employer's Name : Bhushan Ekka
3 . Mobile No : 8889498883
4 . Email Id : bhushanekka71@gmail.co
m
5 . Occupation : Govt.Sector
6 . Monthly Income : 65000
7 . Father Aadhar Number : 690938110722
8 . Phone No (office) : 9479237959

MOTHER'S DETAILS

1 . Name of the Mother's (As per the SSC


Certificate) : Sudha Anita Ekka
2 . Employer's Name : -
3 . Mobile No : 9407783774
4 . Email Id : Sudhaekka79@gmail.com
5 . Qualification : UG
6 . Occupation : Home Maker
7 . Monthly Income : -
8 . Mother Aadhar Card No : 472443383471
9 . Phone No (office) : -

ADDRESS DETAILS

1 . Permanent Address : street-9 street on-031 house


on.-B1
2 . Present Address : street-9 street on-031 house
on.-B1

OTHER DETAILS

1 . Transportation Requirement : No
2 . Medium of the instruction : -
3 . Participation in extracurricular activities (e.g.
Music, Dance, Drawing, Painting etc.) : Dance
4 . Examination passed (specify the Board) : CBSE
5 . School last attended : MGM PUBLIC
SCHOOL,SHANTI
NAGAR, BHILAI (C.G)

MARKS OBTAINED IN CLASS 9TH EXAM

Subject Name Percentage


English 34.5
Mathematics 29.3
Hindi/ Sanskrit 34.5
General Science 33
Social Science 34.5
Overall Percentage/ Grade 33

SIBLING DETAILS ( DOES STUDENT HAS ANY SIBLING IN THE SCHOOL )


Sibling Name Class & Section
- -
- -

GROUP DETAILS

1 . Preferences 1 : 7. English ,
Accountancy,Business Stud. ,
Economics , Informatics
Practices(IP) ( Commerce / IP)
2 . Preferences 2 : 6. English ,
Accountancy,Business Stud. ,
Economics , Maths (
Commerce / Maths)
3 . Preferences 3 : 1. English , Physics ,
chemistry ,Maths , Computer
Science ( Maths / CSC)
4 . Optional subject : Physical Education

DOCUMENT UPLOAD DETAILS

1 . Student Image Upload : Attached


2 . Mother Image Upload : Attached
3 . Father Image Upload : Attached
4 . Xth Mark Sheet (UPLOAD ORIGINAL
SCAN COPY) : Attached
DECLARATION BY THE PARENT/GUARDIAN

I hereby state that my ward ______________________________________________stays with me and that I am


responsible for his/ her proper studies, good conduct and regular payment of the school fees. I undertake to
furnish such report and information concerning him/ her as may be called for at any time by the Principal. If I
withdraw my child before completion of the course, I shall pay all dues as per the directives/rules and regulations
of the school. I also undertake that my ward will follow all the rules and regulations of the school and obey all
orders/directions of the school authorities from time to time. I understand, that violations from the above
undertaking will be resulted to disciplinary action against my ward for which we will be held responsible for the
same.

Date____________________ Signature of candidate Signature of


Parent/Guardian
Place____________________

1. Name_______________________

Signature____________________
(Admin Office)

2. Name_______________________

Signature____________________

Remarks_____________________
(Accounts/Fees Department)

3. Name_______________________ 4. Name_______________________

Signature____________________ Signature____________________
(Shift Incharge) (Teacher Assigned)

Class & group admitted____________________ Admission No. ________________House _____________

Fees Receipt No.______________ Date ____________ Date of admission___________________

SCHOOL SEAL PRINCIPAL

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