TARGET COACHING CENTER, GARAHIYA
PACHPAKRI ROAD GARAHIYA JAMNI EAST CHAMPARAN BIHAR
EMAIL: mdarshadshaikh150051@[Link] 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
