Shri Ram Centennial School Patna

Sr No	__________________
Admission No	__________________

Affix Student's Recent
passport size
photo here

ADMISSION FORM

Session

Instructions

Submit the duly filled form complete in all aspects.
Incomplete forms are liable to be rejected without any intimation.
No form will be accepted without proper documents.
Both Parents must accompany the child for interaction with the Principal.
Except grade Nursery, the admission process will be treated as incomplete if transfer certificate(TC) from the school last attended is not submitted.
Original admission fee receipt to be brought for claiming the caution money.
On advance payment of Annual fee, 10% rebate can be availed.
Sibling concession- As per the admission policy of school.

To be filled in BLOCK LETTERS only.

Student Details
Full name of the student :
Class in which admission is sought:
Gender	Date Of Birth (DD/MM/YY)	Age as on 31 march	Blood Group of the child

Mother Tongue	Nationality	School Transport Required

Type of Family
Religion:
Do you belong to Gen/SC/ST/OBC/EWS/Specify and attach certificate:
Other Information
Name and Address of the last School attended:
Upload Document (Vaccination certificate / Adhar card / Birth certificate / School leaving certificate)

Parent Details
	Affix Mother's Recent Passport size photo here Mother	Affix Father's Recent Passport size photo here Father	Affix Guardian's Recent Passport size photo here Guardian
Full Name
Mother Tongue
Date of birth
Nationality
Educational Qualifications
Occupation
Name of Organization (Pvt./Govt.)
Designation
Office Address with Contact No
Permanent Address
Present Address
Mobile No
Email Id
Annual Income (₹)
Details of Sibling(s) studying in Shri Ram Centennial School Patna
Name	1	2
Class & Section
Certification from the Parent(s)/ Guardian(s)
I/We hereby certify that all the information given is correct and to the best of my/our knowledge. I/We promise to abide by the rules & regulations of the school. Date : ___________________________ Signature: Parent(s)/Guardian(s)

3) Area(s) in which you could contribute to enrich School- Cultural/Medical, Media, Professional/Sports / Academics/ any other.

1
2
3
4
5

4) Areas you think your child needs support and improvement.

1
2

5) Describe strengths of your ward. (Any 2)

1
2

6) Share in brief the daily routine of your child. Wake up time, Meal timings, Outdoor activity time, School timings, Self study at home, Time spent on TV/Gadgets/Reading, bed time.

7) What measures have you undertaken to sensitize your ward about self -awareness and safety measures?

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2
3
4
5

8) How do you develop morals & virtues (feeling of care, compassion, forgiveness, gratitude) in your child?

9) Has your child ever been identified with a learning disability or shown signs of social,physical, emotional or behavioural difficulties? If yes, please tick the appropriate box and attach a medical certificate for same.

(a) Autism	(c) Visual impairment	(e) Any Other
(b) Dyslexia	(d) Physical disability	(e) NA
Any other, please specify

Sibling Rebate Form (20_to 20_)

Name Of Sibling 1
Date Of Birth:	Date	Month	Year
Date Of Joining :

Name Of Sibling 2
Date Of Birth:	Date	Month	Year
Date Of Joining :

Sibling Rebate:	1 Sibling	2 Sibling	Total Rebate
Caution Money	(Amount)	(Amount)
(One Time)

For Office Use Only
Name of the Student		Class admitted to
Age as on 31st March	Student Info
	Name
	Class Admit	Admission No
	Sex: F/M
Supporting documents
Form of Sibling 1
Form of Sibling 2
Accounts Cleared (Sibling 1)
Accounts Cleared (Sibling 2)

All documents have been checked and verified

_________________
Sign. Admission Officer

Note: The Management reserves the right to grant, withdraw or amend the above at any point of time.

List of documents to be submitted:

S.No.	Document Checklist	Yes	No
1	4 Photographs each of Father & Mother (Passport size)
2	5 photographs of the Child (Passport size)
3	A copy of Child's Birth Certificate
4	Progress Report of the last class attended
5	Transfer Certificate(TC) procured from the Previous School
6	Photocopy of Residence proof
7	Photocopy of Aadhar card of Parents and the child
8	CBSE Registration in Previous School (X& XII)
9	Caste Category Certificat
10	Disability Certificate

Undertaking by the Parent(s)/ Guardian(s)

I shall not claim refund of any kind of fee deposited at the time of withdrawal of the student from the School, whatsoever except the Caution money.
The caution money is retained by the school recover the damage or loss to the school caused by the child.
I commit to accept deduction of processing fee as per the School policies.
I declare that the information furnished by me in the form is correct and to the best of my knowledge.
I understand and accept that revision of fee will be undertaken on yearly basis as per School norms.
I shall abide by the fee deposit rules of the School.
I shall abide by the School processes and amendments.

Signature of Parent/Guardian

20-04-2024

Date

Payment Details

Admission Form Fee

Rs. 0

		NOIDA
		GREATER NOIDA
		KAUSHAMBI
		DADRI

A) Radio		H) Pamphlets
B) Neighbours		I) Television
C) News Paper		J) Facebook
D) Website		K) Google Advertisements
E) Hording		L) Word of Mouth
F) Cinema hall		M) Alumni
G) Friends		N) School Exhibition
O) If any other, please specify

(a) Transfer case		(f) Parental engagement
(b) Integrated Curriculum at all levels		(g) Academic attainments at Shri Ram Centennial School Patna of learning
(c) Visibility of Shri Ram Centennial School Patna		(h) Programmes at Shri Ram Centennial School Patna
(d) Co- curricular activities at Shri Ram Centennial School Patna		(i) Sports activities offered at Shri Ram Centennial School Patna
(e) Not satisfied with the Previous School		(j) Nearness to place of residence/ house
(k) Any other