SOS CHILDREN'S ADMISSION FORM VILLAGES No” HERMANN GMEINER SCHOOL,FARIDABAD ‘An English Medium, Co-educational Senior Secondary (10*2) Recent > Affiliated to €.8.8.E., Vide Affiliation No, 230080 Passport ‘Community Project of SOS Children's Villages of india size Form No. FARIDABAD, HARYANA 121008 photograph Class in which admission is sought .. 1. (a) Name of the Child in full (in capital letters) ........ (0) Sex Male Cc Female (__} 2, Date of Birth pa (_[ ) Montn (“JT ) year (“7 | | J In words. een pentton ciamteccacinuerane. YerE= TEE) — nom(eslea)) ow | year in which admission is sought ..Session 5. Category (attach certificate) Tick (1) the correct box Gen. Cat sc st oBc EWS/BPL Disabled SG Child 6. ue | ee | Name of office & Full Address with Telephone No. Full Residential Address with Telephone No./ Mobile No. Permanent Address. 7. Name & Address of local guardian (if any) .. 8. Name & Address of the Schoo! last attended with Clas 9. Whether last school was CBSE affliated .... 10. Ifthe last school was not affiliated to CBSE specify the name of the Board 41, (a) Result of last examination ... 12, For Class Xl only ‘Subjects proposed to offer: 1..... on saya 43, Whether the transfer certificate is attached Yes | No Date of T.C. Parent's Signature ‘Student's Signature DECLARATION BY THE PARENTS | hereby declare that the above information furnished by me is correct to the best of my knowledge & belief | will abide by the rules and regulations of the school. Irena) : es sone Father/Mother/Legal Guardian of .. and all its employee in case of accidentimishap or any inrytomny ward) urna school activities ete, FOR OFFICE USE ONLY Certified that | have checked the application form and the relevant papers are foundin order (Checklist - + Transfer Certificate + Report Card = Birth Certificate + Medical Certificate + Photograph + BPL/EWSCertificate + ProofofResidence + Character Certificate) Date. do indemnify the school Father / Mother / Guardian ‘Admission granted to Class..........Se¢. Fee Receipt No. .... 1 Remarks see Date... Vice Principal/Headmistress | Name has been enteredin he ClassAttendance Register(v) (___} Yes ia) No Certifed that all the entries have been made in the Scholars Register and the dues have been received Registration No. of the student in Admission Withdrawal Register is decisive NOME Dat Office Superintendent ‘Admission considered by the school is in accordance with the provisions of the Board & approved.