KIKANI VIDHYA MANDIR
(Affiliation No: 1930398 )
No.9, RANGASAMY ROAD, R.S PURAM, COIMBATORE-641002
Email:
[email protected] Web: www.kikanischools.org
Phone : 2546180
Application for Admission to the Senior Secondary School
Affix passport size
(Application defective in particulars or in any other manner will photograph of the
not be taken up for consideration) candidate
1. Name of the applicant in full as given in the
School Leaving Certificate / Transfer Certificate
(In Block Letters) ….
2. Date of Birth ….
3. Sex …. Male / Female
4. Nationality / State to which the pupil belongs ….
5. Native Place: Village / Town Taluk District ….
6. Religion ….
7. Community …. BC / MBC / SC / ST / OC
8. a) Whether living with Parent or Guardian ….
b) Local residential address if not living with
Parent or Guardian ….
9. a) Name of Parent / Guardian …. Father Name Mother Name
………………………………… …………………………………
b) Qualification &Occupation ….
c) Address …. ……………………………………………………………..
…………………………………………………………….
…………………………………………………………….
d) Annual Income ….
e) Phone No. / Mobile No. …. Res : Off:
f) Email id ….
10. School last studied ….
11. Board of Affiliation …. ………………………………………………………..
12. Whether recognized …. ………………………………………………………..
Courses Preferred Part - 1 - English
Part - 2 -______________________
Part - 3 -________________________, _______________________, __________________________
13. Mother tongue of the pupil ….
14. Medium in which the pupil studied at the time
of leaving the school ….
I declare that the particulars given are correct to the best of my knowledge. I am aware of the fact that
admission obtained on the basis of false information or suppression of facts will be cancelled on detection at
any time.
Station: Signature of the Parent Signature of the applicant
Date: Date of Interview / Counselling :
DECLARATION BY PARENT / GUARDIAN
I assure that my ward will abide by all the rules and regulations of the institution. In case of default his / her
name may be struck off the rolls and T.C. may be issued.
Signature of the Parent
Courses offered
Subject - 1 - English
Subject - 2 - Choose an elective subject from Academic Electives or Skill
Course
Subject III, IV,V - Any Three from Academic Electives
Or
Two elective subjects from Academic Electives and one subject
from Skill course
Or
One elective subject from Academic Electives and Two subjects
from Skill course
Or
Three subjects from Skill course
Academic electives: Mathematics, Computer Science, Physical Education, Biology
Entrepreneurship, Economics, Physics, Chemistry, Business Studies,
Accountancy, Applied mathematics.
Skill Course: Financial Market and Management, Cost accounting, Food Production,
Banking , Insurance, Tourism, Agriculture. Artificial Intelligence,
Business administration, French, Informatics Practice(New),
Information Technology, Legal Studies, Political Science, Psychology