Gondwana sainiki vidyalaya & uchcha

madhyamik vidyalaya, Gadchiroli

Chamorshi Road, Navegaon, Po-Yeoli Ta + Dist – Gadchiroli, 442 605.
Contact No. Office-9823739488, HM-9404126627, AHM-9405510001
For Office Use Only
Form No…………….. D.O.Form Submission……………………………. Roll No……………….
Mentaly – Fit / Unfit, Physically – Fit / Unfit, Medical – Fit / Unfit
ADMITTED / REJECTED to Std………….. Reg. No…………. D.O.Admission……………………………..
Date -……………………………. Clerk HM/Principal

Note- Incomplete form will not be accepted

Application for Admission to Std - …………. & Hostel

1) Student’s Full Name :- …………………………………………………………………………….………

(In English Capital Letters) ……………………………………………………………………...……

Aadhar No.

2) Date Of Birth

In Word :- ………………………………………………………………………………………………….
3) Place Of Birth :- At- …………………………………………... Po - ……………………….……………
Tah- ……………………………………………Dist-……………………………………
4) Identification Mark :-………………………………………………………………………………………
5) Mother Tongue :-……………………………… 6) Caste/Subcaste -……………………………..

7. ) Category (ST/SC/VJ/NT-B,C,D/SBC/OBC/Open) - ………………………8) Religion - ……..……………………………

9) Domicile – MAHARASHTRA 10) Nationality – INDIAN

11) Last School Studied/Studying -…………………………………………………………………………….

(Name & Address) …………………………………………………………………………......

12) School U-DISE Code -

13) Student ID –

14) Std. Studied Last……………….Medium-……………………. Percentage………………….Grade………….

15) Postal Address (Temporary):-……………………………………………………………………………….....
………………………………………………………………………………………………………………………..
16) Postal Address (Permanent) :- ……………………………………………………………………………………
………………………………………………………………………………………………………………………...
17) Contact Nos. ………………………………………………………………………………………………………
20) Habits, Hobbies, Talents, Temperaments etc- ………………………………………………………………………
…………………………………………………………………………………………………………………………
21) Father’s Guardian’s Full Name :- Shri………………………………………………………………………………
Occupation/Designation :- ……………………………………Annual Income……………………….……………
Office Name :- ………………………………………………………………………………………………………..
Office Address :- ………………………………………………………………………………………………………
Office / Firm Coantact No :- …………………………………………………………………………………………
22) Mother’s Full Name :- Sau./Smt…………………………………………………………………………………….
Occupation/Designation :- ……………………………………Annual Income……………………….……………
Office Name :- ………………………………………………………………………………………………………..
Office Address :- ………………………………………………………………………………………………………
Office / Firm Coantact No :- …………………………………………………………………………………………
23) Annual Total Family Income :- …………………………………………………………………………………….
24) Name of Brothers / Sisters :- ………………………………………………………………………………………
(With Class Studying) ………………………………………………………………………………………..
25) Local person in relation or friend to whom boy may meet or contact in emergency.
Name :- ………………………………………………………………………………………………………………….
Address :- …………………………………………………………………………………………………………………
Contact No :- ……………………………………………………………………………………………………………..
declaration

1. I read the prospectus carefully. I am willing to admit my son / ward in Gondwana Sainiki Vidyalaya & UMV,
Gadchiroli. I give consent and I will have no claims on the authorities for any compensation. I shall not hold
any one responsible if my son / ward leaves the school without written permition of Principal /Vice Principal
/Supervisor/Warden. I shall regularly pay the school, Hostel and Other fees in advance and pay all the incidental
/Tour / Camp / CD/Photo charges expenses at the school before prescribed date.
2. I hereby declare that all the information given in this application is true, complete and correct to the best of my
knowledge & belief. I have read the rules and conditions given in yhe GSV prospectus carefully and I hereby
undertake to abide by them.

Date :- Sign Sign

Student Parent/Guardian
Name……………………………… Name……………………………….

Attached Documents for form Submission

1. Aadhaar Card Xerox -1
2. Passport Size Photo(Current) -2
Attached Documents for Admission
1. Aadhaar Card Xerox -1
2. Passport size Photo (Current) -4
3. Transfer Certificate Original & Xerox -2
4. Marksheet Original & Xerox -2
5. Sanchayi Pustika Original -1 -
6. Stamp Papers 20rs or Above -1
7. Caste Certificate/Validity only ST Student -1
8. Student Bank Passbook xerox if Available -1
 Gondwana sainiki vidyalaya & uchcha
madhyamik vidyalaya, Gadchiroli
Chamorshi Road, Navegaon, Po-Yeoli Ta + Dist – Gadchiroli, 442 605.
Contact No. Office-9823739488, HM-9404126627, AHM-9405510001
ENTRANCE TEST IDENTITY CARD (Keep With Candidate)

Application Form No…………….. Roll No……………………

Admission to Std…………………. Medium of Entrance : Marathi/English

Full Name :-…………………………….………….…………………………………………………………….

Category……………..Date of Birth :…………………………….

Date of Entrance : Written & Dictation-Saturday…………………………. From 10.30am Sharp.

Written & Dictation Result on Same Day at 3.00pm.

If passed physical,Medical, Measurements & Interview on Following Sunday From 8.00am

(Wear Sport Shoes & Comfortable Dress & Inner. No Jeans)

Final Result on Coming Friday From 11.00am

Contact No.- 9405522143, 9423423313 (Clerk)

Gondwana sainiki vidyalaya & uchcha

madhyamik vidyalaya, Gadchiroli
Chamorshi Road, Navegaon, Po-Yeoli Ta + Dist – Gadchiroli, 442 605.
Contact No. Office-9823739488, HM-9404126627, AHM-9405510001
ENTRANCE TEST IDENTITY CARD (Keep With Candidate)

Application Form No…………….. Roll No……………………

Admission to Std…………………. Medium of Entrance : Marathi/English

Full Name :-…………………………….………….…………………………………………………………….

Category……………..Date of Birth :…………………………….

Date of Entrance : Written & Dictation-Saturday…………………………. From 10.30am Sharp.

Written & Dictation Result on Same Day at 3.00pm.

If passed physical,Medical, Measurements & Interview on Following Sunday From 8.00am

(Wear Sport Shoes & Comfortable Dress & Inner. No Jeans)

Final Result on Coming Friday From 11.00am

Candidate have appeared for the following Tests:

Exam Remark Sign of Conductor

1) Written - ………………………………. ……………………………….

2) Dictation - ……………………….……… ……………………………….

3) Running(200M) - ……………Min…………Sec ……………………………….

4) Long Jump(Longest) - ……………Mtr…….……Cm ……………………………….

5) Body Measurment - Ht, Wt, Chest, Waist, L/Shoes, Track Suit No ……………………………….

6) Uniform Measurment- Shirt, Pant ……………………………….

7) Interview Oral - ………………………………… ………………………………

8) Medical - Flat Feet. Knock,General, Dental,Eye,ENT ………………………………

9) Pathology - Blood Group, Sickle Cell ………………………………

10) ………………….. -………………………………….. ………………………………

Candidate have appeared for the following Tests:

Exam Remark Sign of Conductor

1) Written - ………………………………. ……………………………….

2) Dictation - ……………………….……… ……………………………….

3) Running(200M) - ……………Min…………Sec ……………………………….

4) Long Jump(Longest) - ……………Mtr…….……Cm ……………………………….

5) Body Measurment - Ht, Wt, Chest, Waist, L/Shoes, Track Suit No ……………………………….

6) Uniform Measurment- Shirt, Pant ……………………………….

7) Interview Oral - ………………………………… ………………………………

8) Medical - Flat Feet. Knock,General, Dental,Eye,ENT ………………………………

9) Pathology - Blood Group, Sickle Cell ………………………………

10) ………………….. -………………………………….. ………………………………