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ADMISSION FORM HIGHER SECONDARY MATRIC

Date of Application

Medium of Instruction

Tamil Medium

English Medium

Name of the Applicant

Date of Birth

Age in Years

Gender

Male

Female

Blood Group

Nationality & Religion

State to which the pupil belongs

Nativity Details

Town Village

Taluk

District

Community

SC

SCA

ST

MBC

DNC

BC

BCM

BCC

OC

Sub Caste

Whether living with Parent or Guardian

Parent

Guardian

Local residential address if living with Parent or Guardian

Whether Hostel accommodation is required

YES

NO

INFORMATION ABOUT PARENT / GUARDIAN

Father Name

Mother Name

Father Educational Qualification

Mother Educational Qualification

Father Occupation

Mother Occupation

Father Annual Income

Mother Annual Income

Address

Phone Number (with STD Code)

Mobile No

E mail ID

Student Aadhaar Number

Ration Card Number

Class last studied and name of the school last attended and reason for leaving if discontinued

Mother tongue of the pupil

Medium of instruction desired at the time of leaving the school

Medium of instruction desired at the higher secondary stage

From the subjects offered in school indicate in the space provided below the choice of subject under part III

102 English Medium Physics Chemistry Computer Science Mathematics

103 English Medium Physics Chemistry Biology Mathematics

302 English Medium Computer science Economics Commerce Accountancy

422 English Medium Vocational EMA Mathematics

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Declaration

I Declare that particulars given above are correct to the best of my knowledge and I will abide by the rules of the school. I am aware that admission obtained on false information or suppression of facts will be cancelled or detection at any time

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