“Achieve Success Through” BISMILLAH

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SUCCESSFULLY STEPPING INTO 7TH YEAR IN ORDER TO ACHIEVE ONCE AGAIN SUCCESS
A D M I S S I O N F O R M F O R T H E Y E A R 2 0 10 – 11

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STUDENT’S NAME :-
FATHER NAME :-

DATE OF BIRTH :- D D M M Y Y Y Y

ADDRESS : -_________________________________________________
__________________________________________________
__________________________________________________

STANDARD :-

SCHOOL/COLLEGE NAME :-

REGULAR/PRIVATE : - Regular or Private [Tick any one]

CONTACT NUMBER :-

E- MAIL ID :-

SUBJECT TAKEN :-

CARE NEEDED IN : - _________/__________ [write any TWO hard subjects]

ACCESS NUMBER : - OM - (OFFICE USE)

STAMP OF
DATE OF JOINING : - _____/______/2010 (OFFICE USE) OMTEX CLASSES

ADMISSION FEES : - ____________ (OFFICE USE)

Note: -
1. ATTENDENCE IS COMPULSORY 2. IF ANY STUDENT IS BEHAVE WRONGLY OR IN MANNERLY THEN THAT STUDENT WILL BE
DISMISSED INSTANTLY AND NO REFUND OF FEES WILL BE GIVEN. 3. NO ADMISSIONS WILL BE GIVEN FOR SHORT DURATION. 4.
FORM SHOULD BE SUBMITTTED WITHIN ONE WEEK FROM THE DATE OF COLLECTION.

SIGNATURE OF THE STUDENT

SIGNATURE OF THE SIR’S