Modern Convent School
SECTOR 4, DWARKA, NEW DELHI, Delhi-110078
CBSE REGISTRATION OF STUDENTS OF CLASS XI FOR ACADEMIC SESSION 2020-21
[Link] Roll No. 20 Class XI Section B
1 Student's Name: SHASHWAT PRAKASH
2 Mother's Name: MRS. SIDHATRI
3 Father's Name / Guardian's Name: MR. SATYA PRAKASH
4 Sex: Male/Female: Male
5 Cast: General / SC / ST / OBC: General
6 CWSN: NA/Blind/Deaf/Handicapped/Dyslexic/Spastic/Autistic:
7 Subject 1 : Compulsory Language: English
8 Subject 2: Physics
9 Subject 3: Chemistry
10 Subject 4: Biology
11 Subject 5: Physical education
12 Additional Subject , if any:
13 Date of Birth: 16-11-2005
14 Annual Income of Mother & Father Combined:
15 Single Child (Yes or No):
16 Class X Roll No.:
17 Class X Passing Year:
18 Admission No: 4300
19 Date of Admission: 01-04-2010
20 Belonging to Minority Group : Yes / No:
21 Mobile No. of parent: 7045458440
22 Email ID of Parent:
23 Aadhar No.: 660565891707
INSTRUCTIONS :
(i) This form has been filled as per List of Candiates (LOC) Class X . Kindly verify the same with your ward's Class X Marksheet.
(ii) As per CBSE Examination Bye - Laws, the subjects offered by the candiate in Classes XI and XII should be the same.
(iii) Kindly ensure that the mobile number and Email Id mentioned in point no. 21 & 22 is latest.
(iv) Submit duly filled in form along with cheque of Rs. 300/-. at School gate by 21-09-2020.
Please Note :
a. Fee for CBSE Registration is Rs. 300/-. Kindly send a cheque of Rs.300/- in favour of 'MODERN CONVENT SCHOOL MISCELLANEOUS
ACCOUNT'.
b. Kindly mention the name, class, section and admission number of your ward at the back of the cheque..
c. Photocopy of Class X marksheet to be attached along with this form.
d. Subjects opted, studied and passed by the student in Class XI will only continue in Class XII.
e. Mass Media Studies, IT, Marketing & Yoga are Skill Set Subjects.
Undertaking: I have thoroughly checked all the details as filled in for Registration of Class XI/XII Examination of my ward. I would not request for any
change in the details filled in the Registration form of my ward such as Date of Birth / Candidate Name / Father Name / Mother Name etc. If any mistake is
detected before or after declaration of result I will solely be held reponsible for the same.
Signature of Father Signature of Mother
Signature of Student Signature of Class Teacher