Luit Academy

Senior Secondary School

Birat Nagar Chariali, Golakganj, Dhubri (Assam) - 783334

Admission Form (ANKUR - Class 10)

PASTE PHOTO

Student Personal Information

1. Name of Applicant

2. Gender

3. Father's Name

4. Father's Occupation

5. Mother's Name

6. Mother's Occupation

7. Date of Birth

8. Religion

9. Caste

10. Blood Group

Official Identification

11. Aadhar No.

12. PEN Number

13. Student ID

14. UDISE Code

Academic & Contact Details

15. Class Applied For

16. Previous School Name

17. Email ID

18. Contact Number

19. Permanent Address

20. Present Address

Same as Permanent

Guardian's Declaration

1. I will personally bear all educational expenses for my child.

2. I am aware of the fee structure and will pay by the 5th of every month.

3. Commute responsibility is mine; the school is not liable for mishaps on the way.

4. Admission fees are strictly non-refundable.

5. I am bound to follow all rules and regulations established by school authorities.

Date

Parent/Guardian Signature

Documents Attached (Checklist/Upload)

BIRTH CERT.

T.C.

MARKSHEET

AADHAR

PRINCIPAL'S SIGNATURE