TARGET ADMISSION COMPLETE

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TARGET COACHING CENTER, GARAHIYA

PACHPAKRI ROAD GARAHIYA JAMNI EAST CHAMPARAN BIHAR


EMAIL: mdarshadshaikh150051@gmail.com MOB: 9135419001

ADMISSION FORM
1. Class in Which admission sought___________________________Year ___________________________

2. Name of the Ward ______________________________________


(In Block Letters)

3. Date of Birth _______________________________________


(In Figures)

4. Aadhar Number _______________________________________


5. Mothers Name __________________________________________________
6. Fathers/Guardians Name __________________________________________________
7. Occupation : _______________________________________

8. Nationality ___________________________
9. Religion ___________________________
10. Postal Address ______________________________________________________________________
11. Mobile No. _________________________ Alternate No. ___________________________
12. Whether any real brother/sister is studying in this institute? If also please mention name

13. School previously attended.

Name of the school Class Result % Leaving Date

14. Whether a member of SC/ST/OBC/SBC. ______________________


15. Any particular weakness/disability of the child. The institute take note of.___________________________

Declaration by the Parent/Guardian:


I agree to abide by the rules and Regulations of the institute application from time to time. I also accept that
of the institute authorities with regard to disciplinary/academic and administrative matters, is final and binding

Date
Signature of the Father/Guardian Signature of the principal

For office use Only


Registration No. ……………………………………………………

Amount. …………………………………………………… Reciept NO. ……………………………… Dated ……………………………………………

Admitted of Class ………………………………………………………………. Roll No. …………………………………………………………….


Office Incharge

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