Application No -

S142

BARASAT GIRLS' HIGH SCHOOL

(HIGHER SECONDARY)
ESTD - 1976
Class - XI & XII (2021 - 2023)
ASHUTOSH GHOSH ROAD, P.O - BARASAT
NORTH 24 PARGANAS

ADMISSION FORM
Class
Admit
Section Roll No
Amount Rs.
Cashier Date
Headmistress

To
The Headmistress
Barasat Girls' High School
P.O - Barasat, North 24 Parganas

Madam,
I beg to apply for admission to H.S 2 year's course for the session 2021. If admitted, I hereby solemnly declare that
I shall faithfully abide by all rules and regulations of the Institution and the West Bengal Council of Higher
Secondary Education by regular attendance, disciplined conduct both inside and outside the Institution, satisfactory
progress of study and regular payment of dues.

Countersigned Your sincerely

Father QWE XYZ
Mother ASD XYZ Signature in full

1. Name of the Applicant ABC XYZ

(In block letters as in admit card)
2. Languages, Subjects and elective subjects desired to be taken
a) Languages: BENGALI,ENGLISH
b) Elective Subjects: (Student have to select three Compulsory Elective Subjects & One Additional Elective
Subject from any one of the following Sets of Subjects: i.e the choice must be confined to any one of the following
Sets of Subjects)
1. MATHEMATICS
2. PHYSICS
3. CHEMISTRY
4. COMPUTER SCIENCE

3. Any special qualification -----

4) Father's Name QWE XYZ
5) Present Address of
AAAAAA
Father
6) Telephone No 9538778777

7) Mother's Name ASD XYZ

8) Present Address of
AAAAAA
Mother
9) Guardian's Name (if
ASD XYZ
applicable)
10) Present Address of
AAAAAA
Guardian
11) Permanent Address AAAAAA
12) Occupation of
SERVICE
Father / Mother
13) His/Her Monthly
70000
Income
15) Mother
14) Date of Birth 02-10-2006 BENGALI
Tongue
16) Religion HINDU 17) Nationality INDIAN
18) Caste or Creed N.A

(To state clearly if the applicant belongs to scheduled caste or backward class or tribal community)
19) Married or Single SINGLE

20) Institution where the applicant has last studied

Name
Name of Exam Exam Roll
Year Subject Taken of the Division
the School Passed Number
board
BARASAT BENGALI ,
GIRLS' ENGLISH,MATHEMATICS,LIFE SC,
MADHYAMIK 2022 707772N0149 WBBSE FIRST
HIGH PHYSICAL SC, HISTORY,
SCHOOL GEOGRAPHY

21) Marks obtained by the applicant in Board's Examination

Language Group
FL-Written / Full Marks-90 83
FL-Oral / Full Marks-10 0
FL-Total / Full Marks-100 83
SL-Written / Full Marks-90 91
SL-Oral / Full Marks-10 0
SL-Total / Full Marks-100 91
Gr.Total / Full Marks-200 174

Science Group
Mathematics / Full Marks-100 92
P.Sc-Written / Full Marks-90 57
P.Sc-Oral / Full Marks-10 0
P.Sc / Full Marks-100 57
L.Sc-Written / Full Marks-90 72
L.Sc-Oral / Full Marks-10 0
L.Sc / Full Marks-100 72
Gr.Total / Full Marks-300 221

India and Her People Group

History-Written / Full Marks-
77
90
History-Oral / Full Marks-10 0
History / Full Marks-100 77
Geography-Written / Full
85
Marks-90
Geography-Oral / Full Marks-
0
10
Geography / Full Marks-100 85
Gr.Total / Full Marks-200 162

Grand Total Marks 557

Additional / Full Marks-100 0
Division FIRST

22. Original Copy of Character certificate from the HM of the Institution last attended (for students of
other schools), at the time of admission.
23. Attested Copy of Admit Card & Marksheet to be submitted along with the application.
I declare that all statements made above are true to the best of my knowledge and belief.

Countersigned
Father
Mother