* 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 *
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
DETAILS INFORMATION
Whether the candidate is:
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:
CO-CURRICULAR ACTIVITIES
PHOTOGRAPH AND SIGNATURE
PAYMENT