CHELSEA INTERNATIONAL ACADEMY

Cambridge GCE A-Level College

Lakhechaur Marg, New Baneshwor, Kathmandu

ADMISSION APPLICATION FORM

TO BE FILLED BY THE APPLICANTS:

PERSONAL DETIALS

1. Name PHOTO
(BLOCK LETTER) FIRST MIDDLE SURNAME
2. Gender Male Female

3. Date of Birth (D/M/Y) AD (D/M/Y) AD

4. Residential Address in Kathmandu 5. Permanent Address

6. Contact Details
Residence No. Mobile No. E-mail
Whats App/Viber No. SMS Alert No.
7. Parents’ Details
Name Occupation / Office Mobile No.
Father
Mother
Guardian
Contact in case of
emergency other than
Parents/Guardian

8. Academic Details
S.N. Name of the School Last Attended Any case of suspension or Any special honor / Awards
& Address expulsion before (Academic/ Non-Academic)
(if any please mention)
I
II

9. Course Details
1. English General Paper (AS) - Compulsory for all Students
2. Science Stream 3. Non-Science Stream
Physics (A) Economics (A)
Chemistry (A) Business (A)
Biology (A) Accounting (A)
Mathematics (A) Sociology (A)
Computer Science (A) Psychology (A)
Further Mathematics (A) Mathematics (A)
Information Technology (A)
Art and Design (A)
Please choose at least three subjects from above. You can choose subject combination from both Science and Non- Science streams.
Write the subject combination you are interested in studying in A-Level. Indicate A or AS in brackets.

English General Paper (AS)

1. ................................................................... 4. ..............................................................................
2. ................................................................... 5. ..............................................................................
3. . .................................................................

10. Other Details:

I. Please mention your interest and hobbies.

II. Mention about your family and family life in short.

III. Why do you want to study Cambridge A-Level ?

IV. How do you come to know about Chelsea International Academy ?

V. In what ways do you expect Chelsea International Academy to influence you?

VI. Where do you see yourself after 10 years from now, socially as well as professionally ?

VII. Any physical deformities or health problems which need special attention (if any, please mention) ?

11. Declaration:
Sir/Madam,
I hereby request for my admission to Chelsea International Academy. I promise to abide by the school policies,
rules and regulations regarding the payments of fees, student conduct and other school related matters.

For official purpose.

Received by : ………………………………
Signature (Applicant)
Forwarded to : ……………………………
Date (D/M/Y) Date : ………………………………………