Admission under Section 134-A/Session 2019-20 Form: a1@4 a Semeee Appli En Full Name of Childe ITH... a Gender of chile (M/F) Medium (Hind\/Engish). 3. Date birth/ > (AR (DO/MM/YYYY) 7 4. FullNameof Mother 2 4 Full Name of Father fa AH ia Name of School where the Student Passed Previous Clas : assed Recognition APAACBSE/BOSE) Marks Obtained Tota Marks Percentage 7. astorwhchadmision equa Fe ae 8. Student Aadhar Card Number noc : 9, BPL/EWS Ceriteate Number SFT . 10. Lye corte sang Aon BT HA A a ae wt 11, Mobi No ange ona Dea AE FOE 12, Permanent Address/@i) Ades a mo - = ay Tow age MEE / R/T a lo IE Dist fe sate 13, Other Essential Details 3 afar fe Baa EFA oon oe Profession of Parens/ ET RAT BE BE AA 14, Selected Document details ee ee PH ‘No. Bocuments equired/ STAG ETE (at the time of appiieaton) eran 8H Birth Certifieate 4 SEIM TH micie/Residence of Haryana Cerificate PL/EWS Certificate - - Proof of residence any one of the following in order of priority UID Aadhar Card, Passport, Election Photo Identity Card issued by competent authority in the name of parents/ gt wok me Per ce hr a in PARLE15, NameofSchool inorder of preferences /TORTEN tI MIT @ STEW [Note tis larfied that the stent wl not be alloted the same schoo in which he/she ialready studying. Therefore, the students advised not to apply for adjustment in the same school (eee far ar & Ree ah eh ag wt eet ve re Pe a Wet Samm ww t/t ti rate Roa cae donk artes Fare 3 fy ater Ta) 16. Declaration on 1 have read and understand the instructions of this form and the relevant information. The Information inthis form and identification documents provided for this application, ae true and corret tomy knowledge | understand that have provided false or misleading information itmay resutin 3 cancellation of admission, 2 gm ond oh Reve te rae pena wg er 8 te ee Eee ate ome oad af ye aia cet RY ararqae wee we BL A sors rE AK gr Her weg OE A AA eG gL ar aM ah aftran eee wom ty (Signature of Mother/Father) (errr & ero)