Shri Shikshayatan School

Affiliated to C.B.S.E (Regn. No.: SS-00016-1415)

11, Lord Sinha Road, Kolkata-700 071

ACADEMIC SESSION : 2023-2024

Form No. : 230072 APPLICATION FORM FOR ADMISSION TO CLASS - LOWER KG

INFORMATION OF THE CANDIDATE

Name of the Candidate : ARUSHI SAHA Blood Gr. : O+
Date of Birth : 19/04/2019 Age as on 31.03.2023 : 3 yrs 11 months
(As given in Municipal Certificate) Category : OBC
2nd Language : HINDI Nationality : INDIAN Religion : HINDUISM

Single Girl Child : No Specially Abled : No EWS : No

SCHOOL & CLASS IN WHICH CANDIDATE IS STUDYING AT PRESENT

Name of The School : BEGINNERS MONTESSORI Class : PRE PRIMARY Section : 1D

RESIDENTIAL ADDRESS
Address : D/O, CHANDRAJIT SAHA,FLAT NO-401,VEDANTA APARTMENT, Contact No. : 8658091349
48-PULIN AVENUE,MANIKPUR,RAJBARI,AIRPORT 2 1/2 NO GATE,
District : NORTH 24 PGNS Area : AIRPORT 2 1/2 NO GATE City : KOLKATA
Pin No. : 700081 Distance From School : ABOVE 15 KMS

SIBLING DETAILS
Sibling Studying in 0
Name : Class :

FATHER DETAILS

Name : CHANDRAJIT SAHA Phone No. : 8658091349

Qualification : GRADUATE Occupation : ENGINEER
Organisation : GITANJALI PARK, NEWTOWN, KOLKATA, WEST BENGAL 700156, 8658091349
Income Per Annum : 7,20,001 - above Email : arushi.saha2019@gmail.com

MOTHER DETAILS

Name : SUDESHNA RAKSHIT Phone No. : 8170919848

Qualification : GRADUATE Occupation : HOUSEWIFE
Organisation : C/O, CHANDRAJIT SAHA,FLAT NO-401,VEDANTA APARTMENT, 48-PULIN AVENUE,

Income Per Annum : NA Email : arushi.saha2019@gmail.com

DOCUMENTS TO BE ATTACHED & UPLOADED (ALL SELF ATTESTED WITH DATE)

1) Photocopy of the original Birth Certificate. 6) Photocopy of the Category Certificate (if applicable).
2) Photocopy of Progress Report of the previous school. 7) Photocopy of Aadhar Card (if applicable).
3) Character Certificate (if applicable). 8) Specially Abled Certificate (if applicable).
4) Transfer Certificate (if applicable). 9) EWS Certificate (if applicable).
5) Pay Slip / Form 16 / I.T. Return.

Buying an Application Form is not an assurance for confirmed admission.

I solemnly declare that the above particulars are true to the best of my knowledge. I fully understand that my Application Form will stand
cancelled in case the particulars given by me are found to be false or if I fail to submit the required documents on time. I understand that
filling this form does not guarantee admission of the child.

Date : Signature of Parent/ Guardian

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