Admission Form

Relationship with Student

Details of last annual exam.

Relationship with Student

Name of school attended.

Medium of instruction

% of marks

Upload Student Photograph

Upload Parents Photograph

Upload Guardian Photograph

Form No:

Please Select

Old Student New Student

Admission in STD

First Name

Father Name

Grandfather Name

Surname

Address

City

State

Mobile No.

Telephone No.

Date Of Birth

Blood Group

Student last examination details

Last Exam Passed STD

Year Of Passing

Name Of School

Medium Of Instruction

% Of Marks Obtained

Please Upload attested photocopy of last year marksheet as evidence (PDF Format)

Last class attend in Religious Education Center (REC)

Yes No

Has Student any Chronic illness / health problem?
(If Yes Please Give Detail Below)

Yes No

Health Problem Details

**Particulars of non-studying family members**
Name	Age	Relationship with student	Educational qualifications	Occupation	Annual income (Rs.)

Do you receive from or applied to aga khan Education or social welfare board or any other board or trust for any financial assiastance / Scholarship?

Yes No

If Yes, Please provide name and address of Board / Trust

Who will pay your School Fee

DECLARATION OF THE PARENTS/GUARDIAN/STUDENT

I solemnly declare that the particulars submitted in this application form are true to the best of my knowledge and belief.I do affirm that I have read and understood the rules and regulations of the hostel. I hereby agree to abide by all the rules and regualtions of the hostel in forcc from time to time and follow the instructions of the superintendent/warden. I promise to take the responsibility of my ward's behavior during her stay in the hostel. I understand that my wardd is liable for disciplinary action in case of violation of any rules and regualtions of the hostel. I will not hold the hostel management responsible and no legal claim can be filed by me in any court of law against the hostel in case of any untoward incident/event that may happen/occure to my child in terms of health, accident, injury, loss of life in the hostel or on picnic, excursion, study tour, hiking, field trips etc. organized by the hostel and leaving hostel by my child without permission.I will respond to the letters/calls sent by the hostel administration regarding the academic/non-academic undisciplined behavior of my ward.

(Recommendation of Mukhi and Kamadiya Saheb of respective village/center)

We recognize this student and her parents who are permanent members of our Jamatkhana center. We recommend her for admission to Aga Khan Hostel, Sidhpur.

Jamatkhana Center Name

Mukhi Saheb (Full Name)

Mukhi Saheb (Mobile No.)

Kamadiya Saheb (Full Name)

Kamadiya Saheb (Mobile No.)

FOR OFFICE USE

Application Received Date

Interview Date

Medium Of Instruction

Last Year Result %

Current STD

Admission Granted

Yes No

Annual Hostel Fee: Rs.