Name of the Ward to be admitted in the school :

Date of Birth :

Name of the School previously attended with year of admission :

Is your ward suffering from any ailment which requires any emergency treatment/urgent hospitalization :

Blood Group : Blood group A+ A- B+ B- O+ O- AB+ AB-

Own Sister studying in St. Agnes' ( if any ) :

Class : Class UKG I II III IV V VI VII VIII IX X XI XII

1st Language in Qualifying Examination :

2nd Language in Qualifying Examination : ==== Select One ==== Hindi Bengali

Other subjects in Qualifying Examination :

Stream into which admission is sought : === Select One === Science Commerce Humanities

Compulsory subject :

Optional subjects : ==== Select One ==== Hindi Bengali

Extra-curricular interests :

Name of the Father :

Address :

Mobile No. :

Religion : Religion African Traditional & Diasporic Agnostic Atheist Baha'i Buddhism Cao Dai Chinese traditional religion Christianity Hinduism Islam Jainism Juche Judaism Neo-Paganism Nonreligious Rastafarianism Secular Shinto Sikhism Spiritism Tenrikyo Unitarian-Universalism Zoroastrianism primal-indigenous Other

Community(e.g. Punjabi, Bengali etc.) :

Caste : Schedule Caste Schedule Tribe Others

Occupation with address :

Income per month :

Name of the Mother :

Address :

Mobile No. :

Religion : Religion African Traditional & Diasporic Agnostic Atheist Baha'i Buddhism Cao Dai Chinese traditional religion Christianity Hinduism Islam Jainism Juche Judaism Neo-Paganism Nonreligious Rastafarianism Secular Shinto Sikhism Spiritism Tenrikyo Unitarian-Universalism Zoroastrianism primal-indigenous Other

Community(e.g. Punjabi, Bengali etc.) :

Caste : Schedule Caste Schedule Tribe Others

Occupation with address :

Income per month :

Ex-student of this school : Yes No

Name of the Guardian :

Address :

Mobile No. :

Religion : Religion African Traditional & Diasporic Agnostic Atheist Baha'i Buddhism Cao Dai Chinese traditional religion Christianity Hinduism Islam Jainism Juche Judaism Neo-Paganism Nonreligious Rastafarianism Secular Shinto Sikhism Spiritism Tenrikyo Unitarian-Universalism Zoroastrianism primal-indigenous Other

Community(e.g. Punjabi, Bengali etc.) :

Caste : Schedule Caste Schedule Tribe Others

TO BE FILLED IN ACCURATELY AND UPLOADED WITH THE APPLICATION FORM.
If there is any discrepancy in the recorded marks your admission is liable to be cancelled.

  N.B. :

Incase of any subsequent changes in any of the entries made herein, the same has to be communicated immediately, in writing. Incomplete forms and lack of required documents will lead to automatic disqualification of the applicant. I have read the contents of the prospectus and the probationary application form and upon submission of the duly filled-in application form. I state that I have understood the meaning and purport of the rules and regulations as state therein and I declare to abide by and bound by them and accept them in its entirety.

All Enclosures are to be stapled along with this probationary application form and it is to be marked as Enclosure I, II & III. On each Enclosure the form number to be written.
List of Enclosures :
I. Report of VIII.
II. Report of IX.
III. Prospectus [available on website] duly signed by both parents.

Do Not Remove It