THE ROYAL HERITAGE ENGLISH SCHOOLRegd.No.6853 Date -28/05/03

Run By Shri Sanskar Sarita Shikshan Samiti Balaghat

ADMISSION FORM (NOTE- ALL ENTRIES MUST BE FILLED BY PARENT OR GUARDIAN AND BE IN BLOCK LETTERS PLEASE)

To, The Principal / Headmaster

Kindly accept the candidature of my ward and admit her/him as a pupil in your institution.

NAME OF PUPIL

FATHER'S NAME

MOTHER'S NAME

FATHER'S OCCUPATION MOTHER'S OCCUPATION

DATE OF BIRTH IN WORD'S

POSTAL ADDRESS

TELEPHONE NO. RES. MOB. No.

OFF. MOB. No.

MOTHER TONGUE NATIONALITY

RELIGION CASTE

CATEGORY : (SC/ST/OBC/GEN./OTHER)

INDENTIFICATION MARK

CONC. CATEGORY BLOOD GROUP HIGHT WEIGHT

ISHL G SN CE H OE OG LA T BI AR LE AH GL HA AY TO (R M E P.H ).T

AA fo|k ija nSore~ AA AffixRecent

PassportSize

Photographof Pupil

FOR OFFICE USE ONLY

Pupils Name - .......................................................... Father's Name - ......................................................................

Date of Birth - ........................................... In words ........................................................................................................

Admitted in Standard - as Regular / Provisional Enroll No. / Date.

Payment receipt details (a) Annual charges - R.No. / Date Care Charges R.No./Date............................. ....................

Fee concession applied - Brother / Sister / Staff / Management / Poor Student / Other .................................................

Signature of Admission In charge Signature of Principal / Headmaster

(If Student May Be Admitted In This School From Other School)

CLASS IN WHICH ADMISSION WANTED CLASS PASSED BY STUDENT

NAME OF THE SCHOOL FRESH

MEDIUM DISTRICT STATE PERCENTAGE

ENCLOSURE DOCUMENTS (ORIGINAL ALONG WITH PHOTOCOPY)

Birth Certificate Income Certificate Cast Certificate

Two Passport Size Photograph School Leaving Certificate (T.C.) Marksheet of last Examination

Parents / Guardian SignagureDate :

DETAILS OF PRIVIOUS SCHOOL

Recognised-By Govt. of M.P.

COMMITMENT TO EXCELLENCE

MODIFICATION IN BEHAVIOUR IS EDUCATION

DECLARATION - 1

I ................................................................ here by declare that all the information submitted by me along

with this admission form are true according to best of my knowledge. I'will submit the original documents

whenever they may be required by the school management with in given time I'will be fully responsible if any

information found incorrect and the school management and staff will not be responsible for that.

Yours sincerely

Signature and full name

of Parents/ Guardians

DECLARATION - 2 I wish to admit my daughter/son/ward as pupil in your institution . I agree to observe and be bound by all rules of institution . I agree to pay fee on first (but not later than 10th) of every month otherwise I will pay late fee/fine as per rules of institution. I agree to pay all the school dues on demand within mentioned time. I will notify the school of any change of my postal address. I agree to abide by all the rules and discipline of the institution. I have received and read the school rules and instructions (Gen.) carefully, which are mentioned in the prospectus of institution. I Shall cooperate with school management and staff. If school gets any loss the school property by my child, I will bear the loss what ever be.

NOTE :-1- If T.C. is not submitted within time. The admission will be treated as provisional for 3 months only. After that applicant must have to pay re-admission charges along with required documents.2- If student fails to pay care charges regularly for 3 months without suitable reason her/his admission may be terminated without prior intimation. 3- If student may not attend the school more than 21 days without proper reason / application of leave, he/she may be terminated from the school. I have read all instructions carefully and accept it.

Date : Yours truly

Signature of Parents/Guardians