SAINIK SCHOOL BHUBANESWAR

APPLICATION FORM FOR ADMISSION IN CLASS VI / IX (FOR BOYS ONLY)

(Delete whichever is not applicable)

For office use only Application Form No. 1. Registration No. 2. State of Domicile 3. Centre 4. Category SC ST DEF Medium GEN /B/

Paste Passport Size Photograph of the candidate duly attested

DETAILS TO BE FILLED IN BY PARENT AS PER INSTRUCTIONS IN BLOCK LETTERS 1. Name of the Candidate First Name 2. Date of Birth D 3. Place of Birth 4. State of Domicile/Resident 5. Name of Father 6. Name of Mother 7. Name of Legal guardian*
*(if both father & mother are not alive)

Middle Name

Last Name

8. Category

SC

ST

DEF

GEN

9. Occupation & Monthly Income of Parents/ Legal guardian. * If Service holder, indicate serving in Odisha Govt./ Central Govt. /Any other Department.
Relation Occupation Income from Pay + Allowance Income from Property Income from business (if any) Income from any other sources (if any) Total Income per month

Father Mother Legal Guardian 10. If father serving in Defence (Army / Navy / Air Force) or Ex-Servicemen: Rank Discharge certificate No. (for Ex-Servicemen) Number Date

11. Name and Address of the School in which the boy is studying now

Pin 12. Address for Correspondence Pin Tel No. 13. Permanent Home Address E-mail

Pin 14. Centre of Examination (in order of preference) 1.

Tel No. 2.

15. Medium of Entrance Examination 16. Are you prepared to send your son to any other Sainik School if allotted? IF YES, give names of Sainik Schools in order to preference

ENGLISH First Choice Second Choice Third Choice

HINDI

ODIYA

17. Whether willing to educate him as FULL FEE PAYING STUDENT if scholarship is not available. 18. DECLARATION:

YES

NO

(a) I solemnly declare that the particulars given above are TRUE to the best of my knowledge. It is further declared that this is the first attempt of my ward/son for All India Sainik Schools Entrance Examination. (b) In the event of any of the above information being found incorrect at any time, I will have NO OBJECTION for the removal of my ward/son from the rolls of the school. In such case, I also undertake to refund forthwith the full amount of scholarship enjoyed by my son/ward in the Sainik School on demand and without any representation as per the Sainik Schools Rules.

Place: ____________________ Date: ____________________

(Signature of the Parent/Legal Guardian)

GENERAL INSTRUCTIONS/INSTRUCTION FOR FILLING UP THE FORM Use only black ink ball pen for filling up the Form. No cutting should be made in the Form. Attach one extra copy of passport size photograph with the filled Form. Incomplete application forms will be rejected. No alteration in the given format will be accepted.

SAINIK SCHOOL BHUBANESWAR

IDENTIFICATION CERTIFICATE
(To be completed and sent along with Application Form) For office use only Application Form No. 1. Registration No. 2. Centre /B/ 3. Medium
Paste passport size photograph of the candidate duly attested by Headmaster of the School / Gazetted Officer (as applicable)

TO BE FILLED IN BY PARENTS IN BLOCK LETTERS WITH BLACK INK BALL PEN 4. Name of the Candidate
First Name Middle Name Last Name

5. Date of Birth
D D M M Y Y Y Y

6. Name & Address of Father / Mother / Legal Guardian Pin Tel No.

___________________
(Signature of candidate)

______________________________

(Signature of Headmaster of School/ Gazetted Officer with office seal / stamp) Note: The photograph must be attested by Headmaster with Office Stamp. In case boys who have not studied in School it should be attested by a Gazetted Officer.

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SAINIK SCHOOL BHUBANESWAR

ADMIT CARD (CLASS VI / CLASS IX) ALL INDIA SAINIK SCHOOLS ENTRANCE EXAMINATION ____________
For office use only Application Form No. 1. Registration No. 2. Centre /B/ 3. Medium
Paste passport size photograph of the candidate without attestation

TO BE FILLED IN BY PARENTS IN BLOCK LETTERS WITH BLACK INK BALL PEN 4. Name of the Candidate
First Name Middle Name Last Name

5. Date of Birth
D D M M Y Y Y Y

6. Name & Address of Father / Mother / Legal Guardian Pin Tel No.

_________________
(Signature of candidate) Note : Candidate must bring this Card for Entrance Test. This certificate is NOT valid in the absence of the SEAL/ STAMP of Sainik School.