CANTONMENT ENGLISH SCHOOL & COLLEGE CHATTOGRAM CANTONMENT
ADMISSION FORM
□ Defence □ Civil
Applicant ID:……….. Group (For Class-IX):...
Desired class for admission: ... Section:...Class Roll: ...
To be filled up by the office
1. Full Name (In Bengali): ...
In English (Block Letter):...
2. Date of Birth: ... Sex :tick (√) Male / Female 3. Nationality: ... Religion: ... Blood Group: ...
4. Father’s Name (Block Letter): ...
Occupation: ... Organization/ Unit: ...
Designation/ Rank:...Location: ...
Contact No: ... e-mail: ...
5. Mother’s Name (Block Letter): ...
Occupation: ... Organization/ Unit:...
Designation/ Rank:...Location: ...
Contact No: ... e-mail: ...
6. Present Address: ...
...
Telephone Number (Res): ... Mobile: ...
7. Permanent Address: ...
...
Telephone Number (Res): ... Mobile: ...
8. Name of Guardian (other than parents): ...
Relation: ... Occupation: ...
Address: ...
Telephone Number (Res): ... Mobile: ... e-mail: ...
9. Name of previous school:...
10. Medium of Instruction of Last School: ...
11. Class in which the student was last placed: ...
12. For Admission in class VI/IX: PECE/JSC Roll No: ...
Registration No: ... GPA: ... Passing Year: ...
Two Passport size Colour Photographs
Some Important Data about the Candidate
13. Did your son/daughter suffer from any serious ailment? Mark in the appropriate box. Yes No 14. If yes, please state the nature of illness and duration of the ailment. (with dates)
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15. Is your child suffering from any chronic disease which disturbs his / her academic pursuit?
If yes, write its nature
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16. I / We hereby declare that the information furnished in this application form is correct to the best of my / our knowledge. I / We also promise that the child will abide by all the rules and regulations / instructions of the institution.
... ... ...
Signature of Father / Guardian Date:
Signature of student Date:
Signature of Mother Date:
...
Signature of the President/In charge Admission Committee
Date: ...
Approved / Not Approved
Signature of the Principal
Cantonment English School & College
