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MAHARISHI VIDYA MANDIR®

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ADMISSION FORM Nk=k dk orZeku

ikliksVZ lkbt
Ø[email protected]. No. ------------------------ iQkVksxzkiQ ;gk¡
fpidk,a
Passport size
d{kk ftlesa izos'k pkfg, @ l=k @ photograph of
Class in which admission is sought : ........................... Session : ..................... the student

1- (a) fo|kFkhZ dk iwjk uke

Full name of the student (in capital letters) : .....................................................................................................................
(b) fyax @ Sex : iq:"k @ Male L=kh @ Female
2- tUe frfFk (vadksa esa) @ Date of Birth : Day Month Year
'kCnksa esa @ In words : ................................................................................................................................................................................
(l{ke vf/dkjh ds gLrk{kj }kjk tkjh tUe izek.k i=k layXu djsa) (Enclose birth certificate duly signed and issued by the competent authority)
d{kk esa izos'k ds le; 31 ekpZ dks vk;q o"kZ ekl fnu
Age of the student as on 31st March Year Month Day
3- fo|kFkhZ dk vk/kj la[;k @ Aadhaar No. of student :
4. cPps dk jDr lewg @ Blood Group of the student : ...................................................................................................................................
5. D;k vki lkekU; Js.kh@vuqlwfpr tkfr@tutkfr@vks-ch-lh-@vkfFkZd :i ls detksj oxZ@fodykax@bdykSrh dU;k oxZ ls gSa\ ;fn gk¡ rks izek.k i=k layXu djsa
Do you belong to Gen./SC/ST/OBC/EWS/Disabled/Single Girl Child? If yes, attach certificate.
lkekU; Js.kh vuqlwfpr tkfr vuqlwfpr tutkfr vks-ch-lh- vkfFkZd :i ls detksj oxZ fodykax bdykSrh dU;k
General S C S T O B C E W S Disabled S. G. Child

6. ekrk@firk dk C;kSjk Details of parents :

ekrk vkSj firk dk C;kSjk ekrk Mother firk Father
Details of Mother and Father
1- uke Name (in capital letters)

2- jDr lewg @ Blood Group

3. vk/kj la[;k @ Aadhaar Number

4- jk"Vªh;rk @ Nationality

5- eksckbZy ua- @ Mobile Number

6- O;olk; @ Occupation

7- dk;kZy; dk uke] iwjk irk o nwjHkk"k

Name of office & full address
with telephone No.
8- iw.kZ vkoklh; irk o nwjHkk"k
Full residential address
with telephone No.
9- LFkkbZ irk
Permanent Address

10- okf"kZd vk;

Annual Income (in `)
6- LFkkuh; vfHkHkkod dk uke o irk (;fn gks)%
Name & address of local guardian : ..........................................................................................................................................

LFkkuh; vfHkHkkod dk vk/kj la[;k @ Aadhaar No. local guardian : ............................................................................................................

7- vfUre fo|ky; dk uke o irk tgk¡ i<+k gks %
Name & address of the school last attended with class : ..........................................................................................................
8- D;k fiNyk fo|ky; dsUnzh; ekè;fed f'k{kk cksMZ ls lEc¼rk izkIr Fkk %
Whether last school was CBSE affiliated : ...............................................................................................................................
9- ;fn fiNyk fo|ky; dsUnzh; ekè;fed f'k{kk cksMZ ls lEc¼ ugha gS rks lEcfU/r cksMZ dk uke n'kkZ;sa %
If, the last school was not affiliated with CBSE, then specify the name of the Board : ...........................................................

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10- (a) foxr ijh{kk ifj.kke Result of last examination : .......................................... (b) izfr'kr Percentage : .......................................
11- fy, tkus okys izLrkfor fo"k; Subjects proposed to offer 1. .................................................... 2. .....................................................
3. ............................................ 4. ............................................ 5. ............................................. 6. .............................................
12- D;k LFkkukUrj.k izek.k&iz=k layXu gS\ gk¡ ;k ugha ] ;fn gk¡ rks LFkkukUrj.k izek.k&iz=k dh la[;k ,oa fnuk¡d %

Whether the transfer certificate is attached Yes No

If yes then number of certificate : ............................................., Date of Transfer Certificate : ................................................

13- ekr`&Hkk"kk Mother tongue : .......................................................... x`g uxj Home town : ...............................................................

DECLARATION BY THE PARENTS

eSa ,rn~ }kjk ?kks"k.kk djrk@djrh gw¡ fd esjs }kjk nh xbZ mi;qZDr lwpuk esjh tkudkjh esa lR; o lgh gSA
I hereby declare that the above information(s) and/or document(s) furnished by me are correct to the best of
my knowledge & belief.
eaSus fo|ky; ds fu;e o 'krsaZ Hkyh Hkkfr i<+ vkSj le> fy;s gSa ftudks ekuus ds fy;s eSa izfrc¼ jgw¡xk@jgw¡xhA
I have gone through the rules and regulations of the school and I promise to abide by the same.

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frfFk @ Date : ........................... ekrk&firk ds gLrk{kj @ Signature of Parents
 For office use only
1- izekf.kr fd;k tkrk gS fd eSaus vkosnu&i=k vkSj lac¼ dkxtkrksa dh tk¡p dj yh gS rFkk lgh ik;k gSA
Certified that I have checked the application form and the following relevant papers are attached and have found them in order.
1. Transfer Certificate (Original) 2. Birth Certificate 3. Aadhar Copy
4. Blood Group 5. Photograph 6. Mark Sheet
7. Migration Certificate 8. Character Certificate 9. X Class Passing Certificate

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izos'k izHkkjh @ Admission Incharge
2- lac¼ dkxtkrksa ds fujh{k.kksijkUr ,oa 'kqYd izkIrksijkUr d`i;k d{kk -------------------------------------- oxZ ---------------------------------- esa izos'k nsaA
Please admit to Class ............................ Section .......................... after checking the relevant papers and realising the dues.

Admitted to Class ................ Section ................. Fee Receipt No. .................................. Dated ..................... issued.
Details of amount received:
Admission Fee ` ................................
Examination / Annual Charge ` ................................

Caution Money ` ................................

Composite / Tuition Fee ` ................................

Transport fee ` ................................

Computer Fee ` ................................

Other Fee ` ................................

Total Fee ` ................................

d{kk mifLFkfr iaftdk esa uke ntZ fd;k x;kA
Name has been entered in the Class Attendance Register: ( ) Yes No
izekf.kr fd;k tkrk gS fd leLr izfof"V;k¡ Nk=k iaftdk esa ntZ dh xbZ ,oa 'kqYd dk Hkqxrku bl dk;kZy; }kjk izkIr fd;k x;kA
Certified that all the entries have been made in the Scholar's Register and the dues have been received.
fo|kFkhZ dh Nk=k iath;u la[;k (,- MCyw- vkj-) ----------------------------------------------------------------------------------------------------- [k.M%
Registration No. of the student in Admission Withdrawal Register is ................................................ Vol. .....................................

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frfFk @ Date ........................... iz'kklfud vf/dkjh @ dk;kZy; vf/{kd
Admin. Officer / Office Superintendent

Nk=k ds vkosnu dks izos'k gsrq cksMZ }kjk fu/kZfjr ekudksa ds vuqlkj ikrs gq;s Lohdkj@vuqeksfnr fd;k tkrk gSA
Admission considered by the school is in accordance with the provisions of the Board & approved.

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frfFk @ Date ........................... gLrk{kj izkpk;Z ,oa dk;kZy; eksgj
Signature of Principal with office seal