PROVISIONAL ADMISSION FORM

GOVERNMENT SENIOR SECONDARY SCHOOL,NAMTHANG,SOUTH SIKKIM

1. Name in capital
……………………………………………………………………………………………
…………
2. Father’s name
……………………………………………………………………………………………
…………………….
3. Mother’s
Name………………………………………………………………………………………
……………………….
4. Permanent Address
……………………………………………………………………………………………
………….
5. Present Postal Address
……………………………………………………………………………………………
…….
6. Parent’s Occupation
……………………………………………………………………………………………
…………
7. Date of Birth:
In figure Date month year
In
words………………………………………………………………………………………
……………………
8. Registration No.of Class IX ……………………………………………(CBSE)
9. Name of the previous school attended
…………………………………………………………………..
10. Admission for Class……………Stream: Arts/Horticulture/Dairying
11. Vernacular Offered …Nepali/Limboo/Lepcha (Hindi not available)
12.Guardian’s name in case not residing with
parents…………………………………………………………
Occupation ………………………………………………… Address
…………………………………………………… 13. UNDERTAKING: I, solemnly
affirm that I have gone through the rules of the school and that I shall abide by the
same. I shall always be punctual, regular, honest, sincere, obedient and disciplined.
I shall never resolve to violence, disobedience and indulge myself in the use of
unfair means in the exam or any other actions that are found inappropriate in the
exam or any others actions that are found inappropriate in the eye of the school
authority. I shall be not be swept by the emotion, sentiments, prejudices or
instigation. I shall pay my best to keep the name of my school. In case of any break
of discipline, I am liable to any sort of punishment the school authority decides.

______________________________
Applicant’s full name
14. PARENT'S GUARDIAN UNDERTAKING

I hereby assure that my ward............................... Who is taking admission to

class……………………………Stream......................................In the year….........................in this
Institution shall respect and obey all the rules and Regulation of the school.
If she/he found disregarding any norms & codes set forth by the school disrespecting teachers and
their commands, including himself in the school or outside are considered inappropriate by the school
authority she/he is liable to punishment of any type as decided by the school authority. I shall not have
any objection in this place. I shall always extend my full co-operation to the school.

____________________________
Parent’s Signature
……………………………………………..www.namthangschool.blogspot.com………………
…………………………………….
FOR OFFICE USE ONLY
DOCUMENTS TO BE SUBMITTED: PUT MARK on the box if submitted
1. Admit Card of Class X (2009) issued by the Board concerned.(Original and
a Photocopy)

2. For the students from other schools..(other than Namthang SSS) ,Class X -home
Exam(Ist
Term/IInd Term) Progress Report-(Original) and the admit Card as mentioned above.

3. With fee Rs.100.00 (non-refundable)

Provisionally Admitted to………………………………………………… W.e.f.

…………………………………………………………
Admission committee: Signature
1. Mr.B.P.Dhungel ………………………………………..
2. Mr.M.Kharel ………………………………………..
3. Mrs. S.Gurung ………………………………………..
4. Mr. D.M.Tamang ………………………………………..
Principals Signature