Sirjana School

Uttar Dhoka Sadak

01-4530535

www.sirjanaschool.edu.np

[email protected]

ADMISSION FORM

CLASS 11/12

ACADEMIC YEAR 20 /20 BS

PLEASE PRINT AND FILL INFORMATION COMPLETELY. WRITE 'N/A' IF NOT APPLICABLE.

PERSONAL DETAILS

First Name in Block Letters* :

Last Name in Block Letters* :

Name in Devnagari *:

Gender *:

Disability *:

Father's Name *:

Mother's Name :

Nationality *:

Applicant's Contact (Cell Phone Number) * :

Applicant's E-mail ID *:

Parent/Guardian's Contact (Cell Phone Number) :

Date of Birth (According to SEE) in AD *:

Date of Birth in BS - Date/Month/Year :

Permanent Address :

Temporary Address :

Province (Permanent) *:

District (Permanent)* :

Province (Temporary) :

District (Temporary) :

Ward Number (Permanent)* :

Metropolitan/Municipality/RM * :

Ward Number (Temporary) :

Metropolitan/Municipality/RM :

APPLYING FOR (PLEASE TICK ONLY ONE BOX.)

Class 11

Fine Art

Music

Dance

PREVIOUS EDUCATION

Name of the School *:

SEE/SLC Symbol Number :

Passed Year *:

Marks in GPA/Number :

Division :

SEE Marks/Grade in two major subjects

Nepali :

English :

Have you received training on art from any institution or tutor ? If yes, please mention

Institution or Tutor's name :

Duration :

Date :

FINANCIAL SUPPORTER/PARENT/GUARDIAN/SPONSOR

Name *:

Relationship to Applicant :

Address :

Occupation :

E-mail ID :

Cell Phone Number *:

Signature :

THE FOLLOWING ITEMS MUST BE SUBMITTED ALONG WITH THIS FORM TO COMPLETE THE APPLICATION PROCESS

Photocopy of SEE mark sheet and character certificate from the school
Migration Certificate
Photocopy of Citizenship
Recommendation letter -1
Application fee NPR. 1,500 (Non Refundable)

I hereby promise and understand that all the information given by me in this application is true and correct to the best of my knowledge. I have carefully gone through the college propectus and obtained all information.

I sincerely promise that i will strictly abide by all the instructions and restrictions imposed by the college authority. The College authority bears all rights to take any precautionary measures and decisions about me during my term in the college.

ADMISSION FORM

CLASS 11/12

ACADEMIC YEAR 20 /20 BS

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