Kharagpur Vision Academy

ADMISSION

Student Basic Info:

Name*:

Age*:

Date of Birth *:

Place of Birth:

State*:

Gendar* :

Nationality*:

Mother Tongue*:

Religion :

Caste*:

Aadhar No*:

Stream*

Mobile No* :

Present Address(Full Address With Pin Code):

Address*

P.O

P.S

Dist

Pin No

State

Permanent Address(Full Address With Pin Code): Same as Present Address

Address*

P.O

P.S

Dist

Pin No

State

Particulars of Parents and Guardian:

Father's Name:

Email:

Nationality*:

Educational*:

Occupation*:

Aadhar No*:

Mother's Name*:

Nationality*:

Educational*

Occupation*

Mother's Aadhar No:

Guardian or Local Guardian(if any):

Guardian's Name:

Guardian's Mobile No:

Guardian's Aadhar No:

Total Family Income(Yearly)*:

Academic Information:

Name of the Previous

School*:

Class*:

Board*:

RESULTS OF THE LAST ANNUAL EXAMINATION(Pre Board/Board)-2019

First Language :

Second Language:

Life Science:

Physical Science:

Science(ICSE/CBSE):

Social Science (ICSE/CBSE):

History:

Geography:

Additional Subjects:

Aggregate:

Division:

Percentage:

Attested Copy of the Mark sheet :

Transfer Certificate /Character Certificate/Migration Certificate enclosed :

SUBJECTS VII TO VIII & EXTRA CURRICULAR ACTIVITIES (Optional):

SUB:VII(CMPULSORY)	SUB:VIII(COMPULSORY)	GENERAL STUDIES(COMPULSORY)	ART	DRAMA	ELO	QUIZ
Work Exp.(500)	HPE(502)	GST(503)

SUBJECTS SELECTED

(Subject2 & 3-5 must be chosen as per CBSE Scheme Of Studies-2019-2020)

Subject-II :

Subject-III:

Subject-IV:

Subject-V:

Subject-VI:

Compulsory Skill Subject (III-V):

Bus Route:

* indicate for required field.

REGISTRATION & PROVISIONAL FORM FOR ADMISSION TO CLASS XI SESSION 2020-2021 Particulars of the Candidate

ADMISSION

Student Basic Info:

Present Address(Full Address With Pin Code):

Particulars of Parents and Guardian:

Guardian or Local Guardian(if any):

Academic Information:

RESULTS OF THE LAST ANNUAL EXAMINATION(Pre Board/Board)-2019

SUBJECTS VII TO VIII & EXTRA CURRICULAR ACTIVITIES (Optional):

SUBJECTS SELECTED

(Subject2 & 3-5 must be chosen as per CBSE Scheme Of Studies-2019-2020)

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