Opp. Vinayak Farm, Nr.

Saint Paul School, Munjka, Rajkot

Managed by: Savyasachi Shikshan Sansthan, Rajkot

ADMISSION FORM
(FILL IN CAPITAL LETTERS ONLY)
Admission sought in Std: Form No.

Name (In Full)

(Surname) (Name) (Father/ Mot

Birth Date: D D M M Y Y Y Y Nationality:

Birth place: Blood Group:

Religion: Caste:

Previous school attended (if any)

Standard: Percentage obtained in last exam:

Res. Address:

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 Phone No.

Mobile No.

Mother's Name:

Qualification: Occupation:

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 Father's Name:

Qualification: Occupation:

Office Address:

Phone No.

Mobile No.

Guardian Details

Res. Address:

Phone No.

Mobile No.

INFORMATION REGARDING THE CHILD

Allergies (if any:)

Any Physical disabilities (please specify):

Special Talent (if any):

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 Family Physician

Clinic Address:

Phone No.

Mobile No.

DECLARATION

I/We hereby certify that the above information provided by me/us is correct and I/We understand that if
found to be incorrect or false, the ward shall be automatically debarred from selection/admission proces
correspondence in this regard. I/We accept the process of admission undertaken by the school and I/We
decision taken by the school authorities.

Date: D D M M Y Y Y Y

Father Name Signature

Mother Name Signature

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 A. Please attach following along with the admission form:
1 An attested photo copy of the birth certificate and also produce original for verification.
2 In case if the child has attended any other school before please give the attested
photo copy of the last result.
3 Original School leaving certificate.
4 Coloured passport size photographs -6 nos.
5 Original migration certificate in case of transfer from other State.

Fees Submission Dates

1st Term

Last date of completing Term 1 fees submission process is 20 th March,2017.

In case of installments of 1st term fees, it is compulsary to submit post dated cheques of complete am
Maximum of two installments are allowed, that too at the sole discretion of the school management.
Late fees charges Rs 50/-. Per day after the last date, which will be non-negotiable in all cases.

2nd Term

The fees submission date for 2nd Term:15th September to 30th September of current academic sessi
Term is 30th September, 2017.
Late fees charges Rs 50/-. Per day after the last date

I _____________________________________________Father/ guardian of my daughter/son

_______________________________________have read carefully the rules and regulations of Sri Sr
down in the school admission form and having admitted my daughter/son to std.______________ Sri
agree to abide by the rules and regulations of the school, and hereby execute this signature with an a
above mentioned rules & regulations on behalf of myself and my daughter/son. (if guardian mention
student)

Signature of Parent/ Guardian Principal Signature

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 FOR OFFICE USE ONLY

Admitted : YES NO

Std./Division.: Date of Admission: D D

House Name:

Checked by Head Academic/Principal Manage

Amount ___________________ Fee Receipt No._______________ Date:___

Cheque amount: Cheque no

Mode of Payment: yearly 1._________________________ , _________________

Half yearly 2._________________________ , _________________

Quaterly 3._________________________ , _________________

Installments 4._________________________ , _________________

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 B. INSTRUCTIONS
1 Please fill up the form in legible hand writing.
2 Incomplete form is liable to be rejected.
3 Admission and 1st Term fee is to be deposited immediately upon confirmation and no
admission is final till the fees are paid.
4 No refund is allowed under any circumstances once admission is confirmed and fees are
paid.
5 Decision of the management regarding admission is final without having to assign any
reason whatsoever for the same.
6 Any approach or influence for the purpose of admission shall disqualify the child for
admission.
7 Any kind of indecent behaviour by parent/student in school campus can possibly reject
the admission in future.
8 Admission conferred is subject to submission of all necessary documents within in
scheduled time period.
9 Please refer school rules mentioned on last page. Parent's signature is mandatory.

C. IMPORTANT SCHOOL RULES

1 In case of change in phone no., residential or office address of parents/guardian the
school should be informed immediately in writing.
2 It is compulsory to attend all meeting for parents/ guardian.
3 The transportation fees shall be revised as per the requirement & increase in diesel
and petrol rates.
4 Admission to this school is granted as per rules and regulations of the school.
5 No admission is completed until the leaving certificate from the previous school
is produced, countersigned by the Education Officer of the Concerned State.
Migration Certificate should be attached with the application if the public migrate
from another state.
6 There will be raise of minimum 10% in fees every year.
7 No Leaving Certificate will be issue unless applied for in the proper form by the
Parents or guardian writing and after all the dues have been paid.
8 Parents / Guardians / Applicants to confirm that no claims will be made against
the school Management in respect of any loss or injury to the child during the
course of any activities conducted by the school.

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 DISMISSAL
Irregular attendance, habitual idleness, disobedience or defiance of authority, lack of
sufficient improvement in studies and conduct even after warnings or conduct injurious to
the moral of the school are sufficient reasons for dismissal of a student.
For other School rules please refer the School Communicator.

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School, Munjka, Rajkot
n Sansthan, Rajkot

Photo

RM
ONLY)

(Father/ Mother's Name)

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Sri Sri Academy, Rajkot Page 10 Admission Form 2017-18
REGARDING THE CHILD

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 LARATION

me/us is correct and I/We understand that if the information is

debarred from selection/admission process without any
mission undertaken by the school and I/We will abide by the

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mission Dates

20 th March,2017.
o submit post dated cheques of complete amount.
e sole discretion of the school management.

o 30th September of current academic session. Last date for 2nd

Father/ guardian of my daughter/son

d carefully the rules and regulations of Sri Sri Academy School laid
my daughter/son to std.______________ Sri Sri Academy School. I
and hereby execute this signature with an agreement to follow the
and my daughter/son. (if guardian mention relationship with

Principal Signature
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OFFICE USE ONLY

M M Y Y Y Y

Management
Date:_______________

Cheque no:

_____________________________

_____________________________

_____________________________

_____________________________

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ce admission is confirmed and fees are

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