KENDRIYA VIDYALAYA NO.1 SALT LAKE, KOLKATA

OPTION FORM FOR ADMISSION TO CLASS – XI (Session: 2017 – 18)

  1. A. Name of the Candidate: ______(in block letters)

B. Board Roll No. of Class X ______C. Year of passing ______D. Admission No. ______

E. Date of Admission______(DD/MM/YYYY) F. Email.______

2.Father’s Name: ______(in block letters)

3.Mother’s Name: ______(in block letters)

4.Name of the Guardian: ______(in block letters)

5.Relationship with Guardian: ______

6.a. Guardian’s Occupation: CentralGovt./ Central Govt. Undertaking/State Govt./Public Sector/Pvt./Other

b. Admission Category______c. Income of Mother /Father______

7. Official Address:-______

Present Postal Address: ______

Tel: ______Mobile No. (Father)______, Mobile No. (Mother) ______

E-mail Id (of parents): ______

8.(a) Gender:______(M/F),(b) Category:______(Gen/SC/ST OBC/Others)

9.Date of Birth (in figures):______(DD/MM/YYYY)

10. GradeObtained in AISSE 2017: 11. Over All CGPA in AISSE 2017:______

S.No. / Subjects / Grade/Marks / Grade Point / S.No. / Subjects / Grade/Marks / Grade Point
1 / English / 4 / Science
2 / Hindi / 5 / Social Science
3 / Mathematics / 6 / Sanskrit

11. Participation in Sports (SGFI/National/Regional Level) : ______

12. Participation in NCC / Scout & Guide / Adventure Activity : ______

*** Xerox Copies of all documents to be enclosed.

SUBJECT COMBINATION FOR CLASS XI

(Tick {√} the appropriate Box)

SCIENCE STREAM (Minimum Eligibility- above 7.6CGPA and Minimum B1 Grade Science and Maths each

GROUP 1:

Compulsory Subjects --- English, Physics, Chemistry, Mathematics

Optional Subjects------ Computer Science / Bio-Tech/ Sanskrit (Core) /Hindi (Core)

GROUP 2:

Compulsory Subjects --- English, Physics, Chemistry, Biology

Optional Subjects------ Bio-Tech / Mathematics/ Informatics Practices/ Sanskrit (Core)/ Hindi (Core)

COMMERCE STREAM

GROUP 3:

Compulsory Subjects --- English, Accountancy, Business Studies, Economics

Optional Subjects (Any One) ------ Informatics Practices/ Hindi/ Sanskrit (Core)

HUMANITIES STREAM

GROUP 4:

Compulsory Subjects --- English, History, Geography& Political Science

Optional Subjects (Any One) ------Hindi Core / Informatics Practices

UNDERTAKING BYTHE PARENT: I hereby undertake that:

  1. I shall abide my ward with Code of Conduct provided in the student’s dairy.
  2. My ward will be punctual and carry student’s dairy every day.
  3. She/he will attend the Vidyalaya in proper School Uniform.
  4. I will provide balanced food in the Tiffin of my ward.
  5. Any change in the Mobile No. and Addresswill be intimated to the school authorities.
  6. I will make sure to attend all the PTA meetings as per the schedule provided by the Vidyalaya.

Signature of the Student Signature of the Parent

Date:Mobile No:

(For Office Use Only)

Admission (I/C):

______

Verification by the Class Teacher:

______

Approved / Not ApprovedPRINCIPAL