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School, Burdwan
St. Xavier’s School,
Paste Passport
Application Form for Entrance into Class 11 ISC 2019 – 2020
size coloured
SCIENCE ◘ PHOTO
COMMERCE ◘
HUMANITIES ◘
(Indicate your Choice)
Pupil’s Name :
[Full name : (SURNAME first ) one letter per block with space between each name, as per Admission Card]
Board / Council :
School :
Marks obtained in Board / Council Examination :
Father’s Name :
(Full name in block letters)
Father’s Occupation :
Mother’s Name :
(Full name in block letters)
Mother’s Occupation :
(Full designation with address & Phone Number)
Residential Address :
Date :
(1) Opt for only one stream and indicate with a tick mark, the electives you wish to study.
(3) The Principal reserves the right to determine the final choice of stream and subject.
(4) Attendance is obligatory in the School. Students are expected to attend classes everyday without fail.
Statement of Intent
I, …………………………………………….undertake to abide by the norms and spirit of the school and to participate in it’s
programmes of personal growth and outreach.
NAME : ___________________________
Principal
10.05.2019