Luit Academy

Senior Secondary School

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

Admission Form (AHSEC)

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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

11. Email ID

12. Aadhar No.

13. PEN Number

14. Student ID

15. UDISE Code

16. Class Applied For

16b. Stream

17b. Previous Board (e.g., SEBA, CBSE)

17c. Total Marks Obtained in 10th

17. Previous School Name & Place

16c. Subjects Selected (Core & Electives)

18. Permanent Address

19. Present Address

Same as Permanent

20. District

21. PIN Code

22. Contact Number

Transfer Certificate (TC)

Birth Certificate

Last Marksheet

Aadhar Card Copy

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. I have no objection to paying monthly fees during school holidays.

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

5. I am aware the school does not provide electricity, fans, or hostel/refreshments.

6. I will hand over the child at the gate and won't enter classes without permission.

Date

Parent/Guardian Signature