Quality Education Safe Environment Let's learn with fun

S. Authentic Coaching Academy

Bihas Gate, Choddopai, Motihar, Rajshahi-6206. Photo
ESTD-2009
Contact mobile: 01914324476; 01718874363
Contact Email: sujonmegamind@gmail.com

SI.No: Registration:
Roll No: Admission Form of Student Class: Section:

Applicant Full Name : ………………………………………………………………………………………………………………………........

(In Bangla) : ………………………………………………………………………………………………………………………........
Father's Name : ………………………………………………………………………………………………………………………........
Mother's Name : ………………………………………………………………………………………………………………………........
Date of Birth : ………………………………………………………………………………………………………………………........
Birth Certificate No. : ………………………………………………………………………………………………………………………........
Nationality : …………………………………………………… Religion : ...............................................
Height :............................ Weight: ............................. Blood Group : ………………...

Present Address: Permanent Address:

Village : ................................................................. Village : .................................................................
.............................................................................. ..............................................................................
Post office : ............................. Ward No: ........... Post office : ............................. Ward No: ...........
Thana :.................................................................. Thana :..................................................................
District :................................................................ District :................................................................

Mobile Number
Father : .................................................................. Mother : ..............................................................
Guardian NID Number : ………………………………………………………………………………………………………………..
Guardian Annual Income : ………………………………………………………………………………………………………………..
Willing to be admitted to any Class: (Check it out)
Junior Play Senior Play Nursery One Two Three Four Five
Six Seven Eight Nine Ten
I consciously promise that all the above-mentioned information are quite true. I will strictly flow all the
rules and regulations of the school. If fail to maintain the rules of the school, I shall be punished/ banned
my admission of school.
N.B: Student's Certificate will have to be issued according to the above information. So this form will be
fill up very carefully.

Guardian's Signature Director's Signature