AEDUCATION DEPARTMENT

AChandigarh Administration
ASession 2019-20
AAdmission Form
(To be submitted in the school where the candidate has been allotted seat)
FORM NO.: 33011

School Allotted :- GMSSS - 44

Stream Allotted:- Humanities
Name of the Candidate : SHREYA GANDHI
Date of Birth [DD-MM-YYYY]: 6-1-2003
Aadhaar No:
Phone No: 8728993163
Mail ID:
Address: HOUSE NO-584/2 SECTOR-40 A CHANDIGARH
Perm. Address:

City Pin Tel No. with STD Code:

Gender : F
Father's Name PRAVEEN GAHDHI Mobile No: Occupation:
Mother's Name: INDU BALA Mobile No: Occupation:
Guardian's Name: Mobile No: Occupation: Relationship
Guardian's
address
Relationship
Parental Income (Annual):
Record of Xth class

Year of Name of the Name of the Subjects Offered Marks Max. Marks %age of
Passing 10th Board & Roll School Last Obtained Marks
Class No. Attended
2019 CBSE, SRI GURU ENGLISH 86 100 86.00
2357014 HARKRISHA
N MODEL MATHS 33 100 33.00
SCHOOL SCIENCE 52 100 52.00
SEC38 CHD
SOCIAL SC. 56 100 56.00
HIN/PBI/SKT. 80 100 80.00

Result : PASS
Category (Please attach self attested copy of the relevant certificate issued by Competent Authority / self attested copy )
GENERAL

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For Foreign Students:
Passport No.:
Visa valid up to:
Eligibility Certificate:
Residential Permit:
Documents checklist:
1.Marks Sheet issued by Board
2.Character Cert from Head of Institute last attended
3.Category Cert. for admission against Reserved Seats
4.Gradation Certificate for Sports Category
5.Three Passport size photographs

DECLARATION
I, hereby declare that I have read and understood all the information and instructions given in the prospectus. I pledge to
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the rules, regulations and discipline of the institute. I am joining the school with the permission of my parents/guardian. I
solemnly declare that all the facts stated above are true and that I have not been admitted to any affiliated school in the
class to which I am seeking admission in this school. I have exercised my option/choice of school very carefully and fully
understand that I shall not be allowed local migration to any other school later on. I hereby indemnify the school authorities,
Education Department and the Chandigarh Administration for any accident in the school, workshop, playground, work place,
outings or on the way to/from the school. I solemnly declare that I have not been disqualified by any Board, for the
class, that I am joining in the school. I further declare that this is the only form that I have filled in for taking admission
in Class XI of Government School of Chandigarh. In case of any duplicacy, I authorise the authorities to reject my
application for admission at any time without any prior notice.

Signature of the Candidate Signature of the Parents

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