Serial No.
- N Stream Applied for : __________________
Date of issue ………………………. Last date of Submission :
HARINDANGA HIGH SCHOOL (H.S.)
Index – C2-067 (Co-education) Code: 102124
P.O. – Chaberia, P.S. – Falta, Dist.- South 24 Parganas
Telephone No. : (03174) 225169 E-mail ID – harindangahighschool.hs@gmail.com
APPLICATION FORM FOR ADMISSION
TO CLASS XI 20 - 20 3.5 cm. x 2.5
cm passport
1. Candidate’s name (in block letters) ………………………………………………….… size photo to
be pasted
2. (a) Nationality : ………………(b) Religion : …………………… here.
(c) (i) Whether Scheduled Caste / Tribe / OBC-A/OBC-B : ………… (ii) Sub Caste : …………
(d) Whether BPL (Yes/No) : …………………(if yes certificate with score must be attached)
(e) Candidate’s date of birth : …………………………………………………
(f)Sex : Male Female
3. (a)Name of Father :………………………..Educational Qualification………..Occupation……………
(b) Name of Mother :………………………...Educational Qualification………..Occupation………….
(c)Name of the Guardian :…………………..Educational Qualification………..Occupation…………..
( if father/mother is dead or otherwise incapable)
(d) Address (in block letters) : VILLAGE :………………………………………..
POST OFFICE :………………………………… POLICE STATION :………………………………
DISTRICT :…………………………………………PIN CODE :……………………………………..
PHONE NO (compulsory) :……………………… Aadhar No: ………………………………………..
4. Passed Madhyamik Pariksha in the year 20..…
5. Subjects wise Marks with Grade:
Bengali English Math Phy.Sc. Life Sc. Hist Geo Total Percentage
(Excluding
Additional)
Marks
Grade
6. Name of the School last attended : …………………………………………………………
7. Two sets of attested copies of Mark Sheet and Admit Card of Madhyamik Pariksha should be
submitted at the time of submission of application form.
8. One Copy of character certificate should be submitted at the time of admission.
9. Madhyamik Admit Card, Roll ………………. No……………………………………..
10. Subject to be taken up:
a. COMPULSORY 1) Bengali 2) English
b. ELECTIVE SUBJECTS
Science Humanities Commerce
1.Physics 1.Geography /Education 1.Accountancy
2.Chemistry 2.Sanskrit /Political Science 2.Buisness Studies
3.Mathematics 3.History /Philosophy 3.Costing And
4.Biolology / 4. Environmental Science Taxation/Commercial Law And
Computer Application / /Computer Application /Music Preliminaries of Auditing
Computer Science 4.Computer Application
------------------------------------ --------------------------- ----------------------
Signature of the Applicant Signature of Guardian Admit
Headmaster
N.B. – 1. Strike out subjects and group not applicable.
2.Incomplete form shall be rejected.
3.Subjects once taken cannot be changed.
