Admission Form - Model Academy School
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1
2MODEL ACADEMY
The Prestigious School of MIER
B.C. Road, Jammu.
APPLICATION FORM FOR ADMISSION
Session 20
- 20
Date ………………..
Admission No……………………
Attach Coloured
1. Student’s Name (Block Letters) .....................................................................................................................
Passport
Size Photo
duly attested
2. Class in which admission is sought ………………………………………………………………………………..
3. Sex (Male/Female) ....................................................... Category ……………………………………………
4. Date of Birth (DD/MM/YY) …………………………………………………………………………………………
5. Father's Name (Block Letters) ......................................................................... Occupation.................................................
6. Mother's Name (Block Letters) ..........................................................................Occupation..................................................
7. Present Address ....................................................................................................................................................................
....................................................................................... Pin …………………………… Contact No...........................................
8. Permanent Address ...............................................................................................................................................................
..........................................................................................Pin .........................................Contact No........................................
9. Previous Academic Record:
S.No.
School Last Attended
Class
Year
Marks
%age
Regular/
Private
th
th
10. J&K Board Registration No. (For Admission in 9
to 12
Class) ......................................................................................
th
th
For Classes 11
& 12
)
(
Stream : 1. Science
2. Commerce
3. Arts
(Please tick the
11. Subjects Offered:
1. English
2 _______________________
3 _______________________
4 _____________________ 5 ______________________
I solemnly affirm that the date of birth and particulars given above are correct to the best of my knowledge and belief and
that I have reconfirmed the above entries which I certify to be correct. I request that admission may please be granted to
my ward under rules.
Full Name of Parent / Guardian
Signature Parent / Guardian
Admission Granted
Provisionally Admitted
Admission Deferred
Admission Rejected
Date:
Principal
Incharge Admissions
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