UNIVERSAL ACADEMY HIGH SCHOOL
T.R.PATTINAM MAIN ROAD, NERAVY, KARAIKAL.
Ph: 04368-238926 cell:9942936926
Visit us at : www.universalacademykkl.com Email:universalacademykkl@gmail.com
AFILIATED TO CBSE, NEW DELHI CBSE Affiliation No: 2930013 School Code:56810
SI.No. EMIS Admission No…………………
- Name of the Pupil:………………………………………………………………………......................................................
- Name of School which the pupil is leaving: ………………………………………………………………………………..
- Father’s/Mother’s Name:……………………………………………………………………................................................
- Nationality: INDIAN/…………………………………………………………………………………………………...
- Religion, Caste & Sub-Caste: ………………………………………………………………………………………………
- Whether the candidate belongs to Scheduled Caste or Scheduled Tribe or BC or MBC…………………………………...
- Date of birth (in Christian Era) according to Admission Register (in figures): …………………………………………………………………..
(In Words)………………………………………………………………………………………………………………………………………………………………………..
- Aadhaar No:…………………………………………………………………………………………………………………………………………………………………….
- Place of Birth:………………………………………………………………………………………………………………………………………………………………….
- Date of Admission in the school with class: …………………………………………………………………………………………………………………….
- Class in which the pupil last studies (in figures) ……………………………….(in words)……………………………………………………………..
- School/Board’s Annual Examination last taken with result:……………………………………………………………………………………………..
- Whether failed, if so once / twice in the same class: NO/YES –ONCE/TWICE/STUDYING IN STD………………………………………
- Subjects Studied: Tick ( ) the Subjects
- ENG 2.TAMIL/HINDI/FRENCH
3.MATHS 4.SCI 5.SOCIAL SCI
6.PHYSICS 7.CHEMISTRY 8.BOILOGY
9. COMPUTER
- Whether qualified for promotion to the higher class: YES/NO/STUDYING IN STD……………………………………………………………
- Month upto which the pupil has paid school dues: I/II/III/IV Term
- Any Fee Concession availed of : if so, The nature of such concession YES/NO………………………………………………………………….
- Total No. of working days: ………………………………………………………………………………………………………………………………………………
- Total No. of working Days Present:………………………………………………………………………………………………………………………………….
- Whether NCC Cadet/Boy Scout/Girl Guide (Details may be given):
- Games played or Co-curricular activities in which the pupil usually took part(mention achievement level therein) PARTICIPATED IN CO –CURRICULAR ACTIVITIES/& SPORTS, GAMES…………………………………………………………………………………………………………………………………………………………………………….
- General Conduct: ……………………………………………………………………………………………………………………………………………………………
- Date of application for certificate: ………………………………………………………………………………………………………………………………….
- Date of Issue of Certificate: …………………………………………………………………………………………………………………………………………….
- Reason for leaving the school: ………………………………………………………………………………………………………………………………………..
- Any other remarks: …………………………………………………………………………………………………………………………………………………………
Signature of Class Teacher Checked by Principal
(State Full Name and designation)