ATOMIC ENERGY EDUCATION SOCIETY

ONLINE APPLICATION FORM FOR ADMISSION IN CLASS XI IN AECS-4, MUMBAI (ACADEMIC SESSION 2018-19)

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Student ID: 1920MUM04XI7174064

Online Registra on Form

Class of admission XI Mobile No. 9969303808 Email rajeshreyas@gmail.com

Session 2019-20 School AECS-4, Mumbai Category DAE Non-DAE

Child Par culars

First Name SHREYAS Middle Name RAJESH Surname PATIL

DOB 2/10/2004 Gender Boy Girl Category SC

Place of Birth Village Taluka

District MUMBAI State Maharashtra

Home Town Village Taluka

Nearest
(For Railway Concessions only) District CHANDRAPUR Railway CHANDRAPUR
Sta on

Address Details

Official Address Residen al Address

Building Name : RRMD DHRUVA 17 GAURISHANKAR

Address Line 1 : BARC TROMBAY ANUSHAKTINAGAR

Address Line 2 :

City : MUMBAI MUMBAI

State : Maharashtra Maharashtra

PIN Code : 400085 400094

Category

Blood Group O+ CHSS No. 8/18830 D

Parents Par culars

Father/Guardian's Par culars Mother/Guardian's Par culars

Name : RAJESH ARJUN PATIL VAISHALI RAJESH PATIL

Highest Qualifica on : Senior Secondary Gradua on

Monthly Income : 82000 0

Designa on : SR TECH J HOUSE WIFE

Name of DAE Unit : BARC NIL

Telephone No./ Mobile

: 9969303808 9869243808
No.
 Previous School Details

Whether the school

Previous Class School Type Name of the School Medium of Instruc on Name of the Board
is recognised
X CENTRAL GOVT. AECS 2 Yes No ENGLISH CBSE

Sibling Details

Whether studying in AEC

Class Name of the Sibling Name of the School
School
Select Yes No

Select Yes No

Other Details

Mothers Marks of Marks of

MARATHI MOLE ON LS NOSE
Tongue iden fica on 1 iden fica on 2

Marks obtained in class-X board Examina on

English Hindi/Marathi Mathema cs Science Social Studies Total Percentage CGPA

94 100 100 98 95 487 97.4

Please indicate your choice of Subject Combina on (Select the first preference, the other op on will be considered as Second preference)

English, Physics, Chemistry, Mathematics, Computer Science

English, Physics, Chemistry, Mathematics, Biology

Co-curricular Ac vi es Details

Scou ng/Guiding Games/Sports Adventure Ac vi es

SGFI

Na onal Level
Rashtrapa
AEES Level
Rajpurashkar Yes, I had par cipated
State Level
TSTC No, I hadn't par cpated
Regional Level
None of the above
District Level

None of the above

Image Details

Upload Student Image Upload Parent's Signature

(size:25 Kb) (size:12 Kb)
 DECLARATION BY PARENT/GUARDIAN
a) I hereby declare that the informa on given about my son/daughter/ward furnished by me is true and correct and that I will not demand any change in
the date of birth men oned by me in this form at a future date.

b) I am also aware that if the informa on furnished above is found to be false or incorrect, the admission will be cancelled and the child withdrawn from
the school.
c) I shall abide by the rules of the AEC schools (AEES).
Date: ______________ Signature of the Parent/Guardian

Name:

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About AEES

Atomic Energy Education Society (AEES), an Autonomous Body, under the Department of Atomic Energy, Govt. of India, provides education for wards of the
DAE employees upto junior college level.

Contact Info

 Address: Atomic Energy Education Society, Western Sector, Anushaktinagar

 Phone: 022-25509733 (tel:+22-25509733)
 E-mail: innovationaees@gmail.com (mailto:innovationaees@gmail.com)

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