ONLINE ADMISSION
Navnirman High - English Medium School
 
Admission to Class -
 
(As per previous school records/ birth certificate)
NAME OF STUDENT
(IN BLOCK LETTERS) SURNAME FIRST NAME MIDDLE NAME
       
Age : Date of Birth : DD Month Year
   
Polio Dose given Vaccination Mother tongue
     
Place of Birth District State Country
       
Religion Caste - SubCaste Category Nationality
       
Mother’s Full Name
  SURNAME FIRST NAME MIDDLE NAME
       
Qualification Email ID
   
Occupation Position
(Name of the company / Institution and Place)  
   
Mobile No. Office Ph. No.
   
Father’s Full Name
  SURNAME FIRST NAME MIDDLE NAME
       
Qualification Email ID
   
Occupation Position
(Name of the company / Institution and Place)  
   
Landline No. Total Annual Income of Parents
   
Pan Card No. Father’s/ Mother’s Aadhar Card No.: Father’s/ Mother’s
   
Residential Address :
   
Permanent Address :
   
Name and Address of Previous School Studies    
Institution Percentage Year
     
Transportation Facility Required : If Yes Pick Up Point
   
 
PLEASE ATTACH YOU DOCUMENTS
* All Documents are compulsory
Students Photograph - Original Leaving Certificate of Previous School -
   
       
Students Original Marksheet - Students Original Medical Certificate -
   
       
Students Adhar Card - Students Cast Certificate (True Copy) -
   
       
Fathers Adhar Card - Fathers Pan Card -
   
       
Fathers Cast Certificate (True Copy) -    
     
       
   
I/We hereby state that, the information given by me/us is true and correct.
   
 
     
 
 
     
    © 2018 Navnirman High
S.M. Joshi Vidyaniketan, P-63 , M.I.D.C., Mirjole, Ratnagiri - 415 639
Phone : 02352 - 228441. E-mail - navnirmanhigh@gmail.com
 
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