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Admission Form

1) The document is an admission form for Utpal Academy, a higher secondary school in Paro, Bhutan. 2) It collects information such as the student's name, date of birth, citizenship details, medical history, preferred optional subjects, and contact details of parents and local guardian. 3) The form must be signed by both the student and parent/guardian and supporting documents like academic records and ID copies must be submitted along with the form.

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Ter Tshering Lepcha
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113 views2 pages

Admission Form

1) The document is an admission form for Utpal Academy, a higher secondary school in Paro, Bhutan. 2) It collects information such as the student's name, date of birth, citizenship details, medical history, preferred optional subjects, and contact details of parents and local guardian. 3) The form must be signed by both the student and parent/guardian and supporting documents like academic records and ID copies must be submitted along with the form.

Uploaded by

Ter Tshering Lepcha
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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UTPAL ACADEMY

(A HIGHER SECONDARY SCHOOL)


SATSAM, PARO BHUTAN

ADMISSION FORM- 2018


(To be filled in by student)

Applying for Class........................................ Please check one: a. Boarder Day


b. Repeater Regular

Optional Subjects: Maths Economics Rigzhung Computer

Name....................................................................................................................................................................
Sex..............................................Date of Birth....................................................(As per ID and Census record)
Nationality.................................Blood Group......................................................................................................
Citizenship Identity Card No:...............................................................................................................................
Student Code No:..................................................................................................................................................
Medical History (Specify if any)..........................................................................................................................
..............................................................................................................................................................................
Living with Single/Both/Guardian.......................................................................................................................
Previous School/Year...........................................................................................................................................
Reason for leaving previous school......................................................................................................................
..............................................................................................................................................................................
Permanent Home Address:
House No:.....................................................Thram No:..........................................................................
Village...........................................................Gewog................................................................................
Dzongkhag................................................................................................................................................

(Signature of the student)


(To be filled in by parents/guardian at the time of admission)

Father’s Name:....................................................................................................................................................

Identity Card No:..................................................................................................................................................

House No......................................................................Thram No........................................................................

Occupation:...................................................................Telephone No:................................................................

E-mail ID:.............................................................................................................................................................

Mother’s Name....................................................................................................................................................

Identity Card No:..................................................................................................................................................

House No........................................................................Thram No:.....................................................................

Occupation:.....................................................................Telephone No:..............................................................

E-mail ID:.............................................................................................................................................................

Local Guardian (Paro):

Name:...................................................................................................................................................................

Identity Card No:..................................................................................................................................................

Relationship with Applicant.......................................Contact No:.......................................................................

Occupation............................................................................................................................................................

Present Address:...................................................................................................................................................

(Signature of Parent/Guardian)

Important:
Produce copies of progress report, transfer certificate, character certificate, recent passport size photo
(1 no.) and ID Card copies of both student and parents.

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