SYM Educational Trust 273/2022 under ITA 1886

APPLICATION FORM
Session 20 - 20 Date ………………..
Employee No ……………………

Attach Coloured
1. Empolyee Name (Block Letters) ..................................................................................................................... Passport
Size Photo
2. Class that can be handled.............. ……………………………………………………………………………… .. duly attested

3. Sex (Male/Female) ....................................................... Category ……………………………………………

4. Date of Birth (DD/MM/YY) …………………………………………………………………………………………

5. Father's Name (Block Letters) ......................................................................... Occupation.................................................

6. Mother's Name (Block Letters) ..........................................................................Occupation..................................................

7. Present Address ....................................................................................................................................................................

....................................................................................... Pin …………………………… Contact No...........................................

8. Previous Academic Record:

Regular/
S.No. School Last Attended Class Subjects Special Care Remarks
Individual

th th
9. Boards Handled .(For CBSE/State 11 to 12 Class) ......................................................................................
th th
(For Classes 11 & 12 )

Stream : 1. Science 2. Commerce 3. Arts (Please tick the

11. Subjects Offered: 1. English 2 _______________________

3 _______________________ 4 _____________________ 5 ______________________

I solemnly affirm that the date of birth and particulars given above are correct to the best of my knowledge and belief and
that I have reconfirmed the above entries which I certify to be correct. I request that admission may please be granted to
my ward under rules.

Full Name of Candidate Signature

Admission Granted Provisionally Admitted Admission Deferred Admission Rejected

Date: Coordinator Incharge Admissions

Registered Address: # 6, First Floor, O Cross, 12th Street, Krishna Nagar, Pondicherry, Puducherry, India.
 UNDERTAKING
I …………………………………………………… S/o Sh…………………………………………………………………
R/o………………………………………………………………………………………… do hereby solemnly affirm
and undertake to abide by the following terms & conditions:-

1. I undertake regularly to look after the studies and academic progress of my ward and take effective
measures to make up his/her deficiency in studies at all times in consultation with the institute
Authorities.
2. I undertake fully to abide by the policies and decisions of the School Management regarding the
payment of fees and other dues, timings and other academic and administrative matters as notified
from time to time and so long as my ward continues to study in the Institute.
3. That my ward or I shall not join or form any association, action committee or any other group involving
other parents, staff etc., with the purpose of interfering with institute Management, policies and
functioning without the prior approval of School Authorities. Further, I undertake to refrain from
publically condemning or politicizing any issue regarding my ward and his education in the institute in
any manner whatsoever.
4. That I undertake to individually/personally approach the Institution Authorities regarding the solution
of academic problems of my ward. Further, I would extend all my cooperation and help to institute
Authorities to solve such problems as they may arise from time to time.
5. That if the school Authorities find me or my ward contravening any terms or condition of this
Undertaking or Rules and Regulations of the School, they shall be at liberty to strike off the name of
my ward from the rolls of the institute and in that eventuality I shall have no right to challenge the
decision of the institute Authorities in any manner.

Signature
Note by Candidate:

_______________________________________________________

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For Office Use Only

Date of Enquiry ..........………………. …………………………Date of Admission........... .............. Signature…………………..

Class……………….. Entered in web Register by ……..........………… Date ……………………… Signature ………………….

Advance Amount …………………………… Receipt No…………………………………… Date…………………………………..

Admission No. Allotted ………………………………. Class ………………………… Sec……………… Roll No…………………

Incharge Institute Owner