APPLICATION FOR

RAILWAY CONCESSION FORM FOR STUDENTS

(For Home Town Only)
Note: This proforma is to be filled in and handed over to the office at least 7
days before the expected date of booking of the ticket.
PROFORMA
1. Name of the Pupil..................................................................................

2. Class.......................................................................................................

3. Sex : Male/Female.................................................................................

4. a) Date of Birth.......................................................................................

b) completed age...................................................................................

5. Home Town/Village ..............................................................................

6. a) Outward journey from Rly. Station ..................................................

............................................... on date..................................................

b) Name of Railway.................................................................................

7. a) Inward journey from Rly. Station.......................................................

b) Name of the Railway .........................................................................

c) Booking Station..............................................................................

Certified that the home town of my ward as declared above is correct.

Date: Signature of the Parent/Guardian

Name of the Parent/Guardian...........................................................................

(In Block Letters)
Address.....................................................................................................
.......................................................................................................

Sign. of Class Teacher Principal

Concession Form No. and Date of issue

Clerk
 NOTE:-

(a) Railway Concession forms will be issued to the student to travel to and
from Home town Only.

The term "Home" denotes. :

(i) Native Place of the Student

or

(ii) The place where the parent or if no parent is alive the guardian
of the student normally resides.

(b) Application for Railway concession form all the children of a parent
studying in AEC schools should be submitted at one and the same time.

(c) If the children of a parent are studying in different AEC Schools, all their
applications should be submitted in the school where the eldest child is
studying.

(d) Railway concession forms will be issued for Mid-term vacation and
Summer Vacation, but not for Winter break.