M.E.S. Rani Laxmibai Mulinchi Sainiki Shala and Junior College, Kasar - Amboli, Tal.- Mulshi, Dist.- Pune
ADMISSION FORM 2019 - 20 for Std : 11th
STUDENT'S INFORMATION :
( Please fill the correct and detail information .)
1 ) Student's Full Name : *
Your answer
2 ) Date Of Birth :
Date *
Month *
Year *
3 ) Aadhar Card Number : *
Your answer
4 ) Medium Of Education Upto Std - 10th : *
5 ) Board Of 10th Standard : *
6 ) Religion : *
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7 ) Caste : *
NOTE : The candidate other than "OPEN" category must attach relevant caste certificate along with the form.
8 ) Sub Caste : *
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9 ) Name Of The Previous School And Address: *
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10 ) Special Qualities Of The Student :
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Marks Obtained In Std : 10th Perliminary Exam/Board Exam :
1 ) Total Marks : *
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2 ) Percentage : *
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3 ) Mathematics : *
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4 ) Science : *
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Parents Information :
( Please fill the correct and detail information.)
1 ) Father's Name :
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2 ) Qualification :
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3 ) Mobile Number :
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4 ) Aadhar Card Number :
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5 ) Email Address :
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6 ) Permanent Address : *
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7 ) Temporary Address : *
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8 ) Office Address ( If Employee ) :
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9 ) Office Phone Number :
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10 ) Business / Occupation Address :
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11 ) Annual Income :
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12 ) Mother's Name :
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13 ) Qualification :
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14 ) Mobile Number :
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15 ) Aadhar Card Number :
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16 ) Email Address :
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17 ) Office Address ( If Employee ) :
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18 ) Office Phone Number :
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19 ) Business / Occupation Address :
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20 ) Annual Income :
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21 ) Local Guardian's Full Name :
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22 ) Mobile Number :
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23 ) Address :
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24 ) Aadhar Card Number :
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25 ) Email Address :
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Place : *
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Date : *
MM
/
DD
/
YYYY
Postal Address :
M.E.S. Rani Laxmibai Mulinchi Sainiki Shala and Jr. College, Gat No. - 80 C, At - Kasar - Amboli, Post - Pirangut, Taluka - Mulshi, Dist. - Pune - 412115
Contact Numbers :
84120 14941 / 84120 14934
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