Admission Form - Bootstrap 5 Version

Basic Details

Date

Student Name (Tamil) *

Student Name (English) *

Date of Birth *

Email *

Mobile No. *

Aadhaar No. *

Gender *

Religion *

Caste *

Category *

Nationality *

State *

Birth Place *

Community Certificate *

Allowed: PDF/JPG/PNG.

Residential Details

Are you residing with parents or with a guardian? *

Name *

Occupation *

Annual Income *

Only Numbers Allowed.

Address *

District *

Taluk *

State *

Pincode *

Academic Details

Qualifying Examination Passed *

Name of the Examination Board *

The marks obtained in the qualifying examination must be duly attested either by the Headmaster of the school last studied or by a Gazetted Officer. The original mark certificate should NOT be sent along with the application. Only the attested copy of the mark statement should be enclosed with the application. The original mark statement must be produced at the time of admission.

Public Examination Marks

Name of the Examination Passed *

Month and Year of Examination *

Examination Register Number *

Subject	Max Marks	Marks Obtained
TAMIL
ENGLISH
MATHEMATICS
SCIENCE
SOCIAL SCIENCE
Overall:
Percentage:

Preferred Course Details

Please specify the order of preference for the stream you wish to study.

Course Preferred to Study *

Year of Admission (First Year / Second Year) *

Preferred Group 1

Preferred Group 2

Preferred Group 3

Mother Tongue *

Medium of Instruction at the Time of Leaving School *

Last Studied Details

Last Studied Class *

Year of Study *

Name of the Last Studied School*

EMIS No. *

Reason for Leaving or Discontinuation *

Other Details

NCC / NSS / Scouts / Guides / Red Cross – Would you like to join?

Yes

Smallpox Vaccination Taken?

Yes

Certificates for Co-curricular Activities

Allowed: PDF/JPG/PNG.

Place *

Student Image *

Allowed: JPG/PNG.

Alagappa Model Hr. Sec. School