NEW SUNBEAM PUBLIC SCHOOL

The School of Excellence

Coat Ward, Near Punjab National Bank, Khanpur, Bulandshahr

APPLICATION FORM FOR ADMISSION

Session 2020 - 2021
Admission No…………………… Date ………………..

Attach Coloured
1.Student’s Name (Block Letters) .................................................................................................................. Passport
Size Photo
2.Class in which admission is sought ……………………………………………………………..……………….. duly attested

3.Sex (Male/Female) ....................................................... Category …………………………………….……

4. Date of Birth (DD/MM/YY) …………………………………………………………………………………………

5. Father's Name (Block Letters) ......................................................................... Occupation.................................................

6. Mother's Name (Block Letters) ..........................................................................Occupation..................................................

7. Present Address ....................................................................................................................................................................

....................................................................................... Pin …………………………… Contact No...........................................

8. Permanent Address ...............................................................................................................................................................

..........................................................................................Pin .........................................Contact No........................................

9. Previous Academic Record:

S.No. School Last Attended Class Year Marks %age Regular/

Private

10. Board Registration No. (For Admission in 9th to 12th Class) ......................................................................................
th th
(For Classes 11 & 12 )

Stream : 1. Science 2. Commerce 3. Arts (Please tick the

11. Subjects Offered: 1. English 2 _______________________

3 _______________________ 4 _____________________ 5 ______________________

I solemnly affirm that the date of birth and particulars given above are correct to the best of my knowledge and belief and
that I have reconfirmed the above entries which I certify to be correct. I request that admission may please be granted to
my ward under rules.

Full Name of Parent / Guardian Signature Parent / Guardian

Admission Granted Provisionally Admitted Admission Deferred Admission Rejected

Date: Principal Incharge Admissions

 UNDERTAKING
I …………………………………………………… S/o Sh…………………………………………………………………
R/o………………………………………………………………………………………… do hereby solemnly affirm
and undertake to abide by the following terms & conditions:-

1. I undertake regularly to look after the studies and academic progress of my ward and take effective
measures to make up his/her deficiency in studies at all times in consultation with the School
Authorities.
2. I undertake fully to abide by the policies and decisions of the School Management regarding the
payment of fees and other dues, timings and other academic and administrative matters as notified
from time to time and so long as my ward continues to study in the school.
3. That my ward or I shall not join or form any association, action committee or any other group involving
other parents, staff etc., with the purpose of interfering with School Management, policies and
functioning without the prior approval of School Authorities. Further, I undertake to refrain from
publically condemning or politicizing any issue regarding my ward and his education in the school in
any manner whatsoever.
4. That I undertake to individually/personally approach the School Authorities regarding the solution of
academic problems of my ward. Further, I would extend all my cooperation and help to School
Authorities to solve such problems as they may arise from time to time.
5. That if the school Authorities find me or my ward contravening any terms or condition of this
Undertaking or Rules and Regulations of the School, they shall be at liberty to strike off the name of
my ward from the rolls of the School and in that eventuality I shall have no right to challenge the
decision of the School Authorities in any manner. In Witness whereof I sign this undertaking in
presence of Witness this __________________ day of 20.

Parents / Executants

Witness (Name & Address)

1. ___________________________ Name ________________________

___________________________ ________________________

___________________________ ________________________

2. ___________________________ Address______________________

___________________________ _______________________

___________________________ _______________________

For Office Use Only

Date………………. Entries verified by …………………………………Date……………….............. Signature…………………..

Class……………….. Entered in Admission Register by ……………… Date ……………………… Signature ………………….

Security Amount …………………………… Receipt No…………………………………… Date…………………………………..

Admission No. Allotted ………………………………. Class ………………………… Sec……………… Roll No…………………

Entered in the Student Database by…………………………………………………………………………………………………….

Incharge Admissions Administrative Officer