Admission Form

* fields are mandatory

DECLARATION

I / We solemnly state that I/we have not approached, lobbied or paid or promised to pay donation for admission to ST. XAVIER'S HIGH SCHOOL, MUSHALPUR ,BARIMUKH (MUSHALPUR), BAKSHA(BTAD), ASSAM - 781372 . I / We agree to the cancellation of the admission of my child if any such illegal practices are proved by the school management at a later stage. I / We do hereby agree to abide by the rules and regulations of the school and schedule of fee and payments as amended by the school at its discretion from time to time.

I / We, hereby, declare that, the entries made by me in the Application Form are complete and true to the best of my knowledge and based on records.

The management reserves the right to admit or reject any application for the admission without giving any reason.

NOTE: Form once submitted student’s name, parent’s name and DOB cannot be changed.

PERSONAL DETAILS OF CANDIDATES

Class *    
First Name *
Middle Name
Surname *
Gender *    
Date of Birth *
 -   - 
Age * (as on 31/03/2022)
Caste *

Attested copy of caste certificate must be submitted during admission time if other than General.

Nationality *
Community *
Mother Tongue *
Blood Group *
Identification Mark
Disease or any serious illness for which child is on regular medication
Do you authorize the Principal to approve the administration of any medication as advised by the medical officer in an emergency when you cannot be contacted immediately

COMMUNICATION

Residential Address *
City *
State *
Postal PIN Code *
E-mail Address *
Primary Mobile No. * For school contact.
Secondary Mobile No. * Emergency purpose only.
WhatsApp Mobile No. *
Distance From ST. XAVIER'S HIGH SCHOOL, MUSHALPUR *

COMMUNICATION ADDRESS

Father's / Guardian's Name *
Education Qualification *
Mobile Number *
Office/ Bussiness Address
Occupation & Designation *
Annual Income *
Mother's / Guardian's Name *
Education Qualification *
Mobile Number *
Office/ Bussiness Address
Occupation & Designation *
Annual Income *

LAST SCHOOL INFORMATION

Last School Name *
Last School Address *
Last Class Attended *

TRANSFER CERTIFICATE DETAILS

Transfer Certificate No.
Date of Issue.

ADDITIONAL INFORMATION

Detail(s) of any Brother(s)/Sister(s) Studying in ST. XAVIER'S HIGH SCHOOL, MUSHALPUR:
Admission No. Name Gender Class Sec

PAYMENT