Admission Form

* fields are mandatory

DECLARATION

I / We solemnly state that I/we have not approached, lobbied or paid or promised to pay donation for admission to ST. MARY'S SENIOR SECONDARY SCHOOL ,WARD NO.6 , CHABATI , NORTH LAKHIMPUR - 787001, ASSAM . I / We agree to the cancellation of the admission of my child if any such illegal practices are proved by the school management at a later stage. I / We do hereby agree to abide by the rules and regulations of the school and schedule of fee and payments as amended by the school at its discretion from time to time.

I / We, hereby, declare that, the entries made by me in the Application Form are complete and true to the best of my knowledge and based on records.

The management reserves the right to admit or reject any application for the admission without giving any reason.


NOTE: Form once submitted student’s name, parent’s name and DOB cannot be changed.

PERSONAL DETAILS OF CANDIDATES

Class *    
First Name *
Middle Name
Surname *
Gender *    
Date of Birth *
 -   - 
Age * (as on 31-03-2025)
Caste

Attested copy of caste certificate must be submitted during admission time if other than General.

Nationality *
Community *

If Roman Catholic, letter of the paris priest to be submitted during admission time.

Mother Tongue *
Blood Group *
Identification Mark
Disease or any serious illness for which child is on regular medication
Do you Authorize the principal to approve the administration of any medication as advised by the medical officer in an emergency when you cannot be contacted immediately

COMMUNICATION

Residential Address *
City *
State *
Postal PIN Code *  
E-mail Address *  
Primary Mobile No. * For school contact.
Secondary Mobile No. * Emergency purpose only.
WhatsApp Mobile No.
Distance From ST. MARY'S SENIOR SECONDARY SCHOOL *

COMMUNICATION ADDRESS

Father's / Guardian's Name *
Education Qualification *



Cell Phone Number  
Alternative Cell Phone Number  
Office/ Bussiness Address Father's/ Guardian's Address *
Occupation & Designation *
Annual Income *
Mother's / Guardian's Name *
Education Qualification *



Cell Phone Number  
Alternative Cell Phone Number  
Office/ Bussiness Address Mother's/ Guardian's Address
Occupation & Designation *
Annual Income *

DETAILS INFORMATION

Whether the candidate is:
Single Girl Child
Especially Abled(Divyanngjan)
Belonging to the EWS:
(Economically Weaker Section)
Category:
Aadhar (Optional):

TRANSFER CERTIFICATE DETAILS

Transfer Certificate No.
Date of Issue.

ADDITIONAL INFORMATION

Detail(s) of any Brother(s)/Sister(s) Studying in ST. MARY'S SENIOR SECONDARY SCHOOL:
Admission No. Name Gender Class Sec

CO-CURRICULAR ACTIVITIES

Literary & Cultural

Details of Awards or Achievements
  Debate
  Quiz
  Dancing
  Instrumental Music   
  Singing
  Drawing & Painting
  Others

Sports

Details of Awards or Achievements
  Basketball
  Football
  Vollyball
  Table Tennis   
  Karate
  Badminton
  Cricket
  Yoga
  Others

PHOTOGRAPH AND SIGNATURE

Photograph of the Candidate
(Max size 200 kb.)
Photograph of the
(Max size 200 kb.)
Photograph of the
(Max size 200 kb.)

PAYMENT