ATOMIC ENERGY CENTRAL SCHOOLS

Cost: Nil

Application Form for Admission to Class I only

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For the Academic Year 2015-16

For admission in Class I under the provisions of RTE Act

(This form can be viewed (read-only) from www.aees.gov.in)
Sr. No.

2015/

Admission No. ________________ (For Office Use)

To
The Principal

SC

ATOMIC ENERGY CENTRAL SCHOOL - _____________

___________________________________________
Sir/Madam,
I request you to admit my son/daughter/ward to class
below:
1.
Name of the pupil in full
(in block letters and as stated in the Birth
Certificate)
2
Date of birth
D

OBC

BPL

(Tick () in appropriate box)

__________ of your school. The required particulars are given
Surname
In figures
M

First Name

Middle Name
In words

Place of birth

4
5

Age as on 31st March of the year of admission

Male / Female
a) Name of the father in full (in block letters)
a)
b) Name of the mother in full (in block letters)
b)
Official address with designation of the parent
(father and/or mother)
Complete Residential address with address proof
Aadhaar Card/Ration Card no. of the child & Blood
Group
Monthly income of the parents
Telephone No. (if any)
Office: __________________ Residence: ___________________
Mobile: __________________ E-mail: ______________________
Creche: _________________ Emergency contact no. __________
Village: __________________ Taluka: ____________________
Name of the home town of the child
Dist. _______________ Nearest Rly. Stn. __________________

6
7
8
9
10
11
12
13
14
15
16
17

Village:
Dist.:

ST

Mother tongue of the child

Whether the child belongs to SC/ST/OBC/Other
(Please enclose a copy of the caste certificate in
the name of the child.)
Identification Marks (any two)
1.
2.
Any other information which the parent/guardian
wishes to furnish
Distance of residence from the school to which
admission is sought
Whether the child belongs to weaker section
(Please attach certificate)

Taluka:
State:
Gender

DECLARATION BY PARENT/GUARDIAN
a) I hereby declare that the information given about my son/daughter/ward (name of the child)
________________________________ furnished by me is true and correct and that I will not demand any change in the date
of birth mentioned at serial 2 at a future date.
b) I am also aware that if the information furnished above is found to be false or incorrect, the admission will be cancelled and the
child withdrawn from the school.
c) I shall abide by the rules of the AEC schools (AEES).
Date: ______________

Signature of the Parent/Guardian

Name:
________________________________________________________________________________________________________
OFFICE USE
Admit _______________________________________________ to Class _________. Admitted to the Class _________
Admission no. ________ Folio no. ________ Receipt No. ____________. The name has been entered in the class register.
Date:
Class Teacher
Principal
.......
ENCLOSURES RECEIVED
1. Original Birth Certificate alongwith an attested copy is to be submitted at the time of admission. Certificate of proof of age if in
the form of a birth certificate issued by the authority competent to register births will include certificates from Notified Area
Council/ Municipality/ Municipality Corporation extract about the date of birth from records of Village Panchayat.
2. A certificate that the child belongs to the Scheduled Caste/ Scheduled Tribe/ EWS/OBC (Non-Creamy Layer)/ BPL/ Differentlyabled, wherever applicable, issued by the competent authority in concerned State Government/ Union Government. The
certificate as applicable in respect of either of the parents may be accepted initially, for the purpose of admission, if this
certificate is not available for the child. However, the certificate in respect of the child has to be submitted within a period of 03
Months from the date of admission.
3. A Certificate from the civil surgeon/rehabilitation centre or any other competent authority defined by the Government of India
certifying the child to be handicapped, wherever applicable. In case, where the handicap of the child can be visually seen by
the Principal, the child may be accepted as handicapped even without a certificate. However, the parent may be advised to
obtain the relevant certificate from the competent authority and submit the same to the school.
4. Attested copies of Aadhaar card/Ration card of parents alongwith the same of the child.
5. Income Certificate in respect of parents issued by the employer concerned/ Revenue authorities
6. Proof of residence (essential) and distance from the school:
Note : A self-declaration in writing from the parent about distance of the residence from the school in which
admission is sought may also be accepted to this effect.
7. Any other document(s) as advised/required by the Head of AEC School for the grant of admission.

Sr. No.

2015 /

RECEIPT

AECS- ___________received an admission form from Master/Miss _________________________________ son/daughter of

_____________________________________ for admission to Class ___________.
I have personally verified copies of the required documents/enclosures which are attached herewith.
Date:

(Dealing Assistant)