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Application Form for the session 2015-16 - Sainik School Ghorakhal

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ADMISSION STRICTLY FOR BOYS ONLY
(To be filled by the School Office)
Form No
_______________
Received Date _______________
(To be filled by the School Office)
Roll No
_____________/GK
Category
____________
Checked & initialed by ________
SAINIK SCHOOL GHORAKHAL, NAINITAL, UTTARAKHAND – 263156
APPLICATION FORM FOR ADMISSION : ACADEMIC YEAR 2015-16
READ INSTRUCTIONS CAREFULLY BEFORE FILLING UP THE APPLICATION FORM
FILL ALL COLUMNS IN LEGIBLE CAPITAL LETTERS USING A4 SIZE WHITE PAPER
1.
Class for which admission is sought - (VI or IX)
2.
Candidate’s Date of Birth
3.
Candidate’s Place of birth ____________ 4. Candidate’s Blood Group _______
5.
Height ______ cms 6. Weight _____ Kgs. 7. Eye Vision R _______ L _______
8.
Name of school previously attended with Class & Medium
Day
Session
9.
_________
Month
Latest Passport size
photo to be pasted and
attested by the Head of
the institution where the
student is presently
studying.
Year
Name of the School with complete
address
Class
Medium
Name of the boy in Full (CAPITAL LETTERS ONLY)
10.
Father’s Full Name (CAPITAL LETTERS ONLY)
LAST DATE FOR
SUBMISSION OF
APPLICATION FORM
06th DEC 2014
(SATURDAY)
11.
Mother’s Full Name (CAPITAL LETTERS ONLY)
EXAMINATION DATE
04th JAN 2015
(SUNDAY)
12. Full Name of the Guardian (CAPITAL LETTERS ONLY) (If Parents are not alive)
13. Relationship to the boy ___________ 14. Nationality __________ 15. State of Domicile (Parents) ___________
16. Religion ________ 17. Please Tick ( ) your category in the box
General
Defence
SC
ST
(a)
If you belong to SC / ST category, please specify your Sub Caste/Tribe________________________
(Attach photo copy of caste certificate issued by the competent authority).
(b)
If you belong to DEFENCE category, please furnish the following details :Whether serving
or Ex-service
personnel
Service
Number
Rank
Date of
Date of
Name of the Record Office
Enrolment/ Discharge
Commission
18.
Monthly Income from all sources Rs _________________
19.
Occupation of Father / Mother/ Guardian __________________/___________________/_______________
(Government/ Private Service/Business/Farming etc. to be specified)
……. 2
-220.
Registration Fee :- To be deposited in any SBI Branch through attached Challan Form and details of the
deposited Challan Form to be furnished in the boxes given below :NAME OF THE SBI BRANCH BRANCH CODE NO JOURNAL NO
AMOUNT
DATE OF DEPOSIT
(where Registration Fee
(at Challan Form (at Challan Form DEPOSITED
(at Challan Form
deposited given at Challan
Sl. No 3)
Sl. No 4)
(at Challan Form
Sl. No 6)
Sl. No 5)
Form Sl. No 2)
SBI
/
/ 2014
NOTE :- School Copy of Challan Form to be sent alongwith the Application Form. Bank Draft/Cheque
will not be accepted by the school.
21.
22.
Permanent Address:-
P
I
N
P
I
N
Address for Correspondence:-
23.
Land Line No. with STD Code __________________, Mobile ________________ & __________________
e-mail ID if any ____________________________
24.
Choice of Examination Centre
- i) __________________ ii) ___________________ iii) ______________
(Please see attached instruction page No 4 & 6 Sl. No 7)
25.
Has your son/ward appeared in entrance examination earlier? If yes, please give the following details:Name of the Centre
Year
Roll Number
Class
26.
(a)
If you are willing, give the names of three choices of Sainik Schools in order of preference. (THIS
WILL BE CONSIDERED ONLY IF VACANCY EXISTS IN OTHER SAINIK SCHOOLS). Please see
attached page No 5 & 7 Sl. No 14.
Choices :- (i) Sainik School ______________ (ii) Sainik School ____________ (iii) Sainik School _____________
(b)
I hereby give undertaking that I am willing to admit my son/ward as FULL FEE PAYEE CADET in
other Sainik Schools as indicated above and “under any circumstances will not seek inter-school transfer
till the completion of studies of my ward from that Sainik School once he is selected/admitted”.
__________________________
Signature of the Parent/Guardian
27.
Special achievement in sports and other fields:-
DECLARATION BY THE PARENT
I solemnly declare that the particulars furnished above are true and no information has been concealed. In
case any of the above information found incorrect at any time, I will have no objection for removal of my son from the
school and refund the scholarship amount if availed. Orders and Instructions given/issued from time to time by the
Principal will be binding on me.
_____________________________
Date _____/______/2014
Place _______________
Signature of the Parent/Guardian
Full Name ____________________
The following documents to be submitted before due date :- (1) Application Form, (2) Hall Ticket (3) School Copy
of Challan vide which registration fee deposited in SBI Bank (4) Self Addressed envelope with Rs 22/- postage stamps
affixed (5) Attach photo copy of SC/ST Certificate (if the candidate belongs to SC/ST)
…………… 3
-3-
HALL TICKET
SAINIK SCHOOL GHORAKHAL, NAINITAL, UTTARAKHAND - 263156
FOR ENTRANCE EXAMINATION 2015-16
Centre of Examination __________________________________ Roll No ___________/GK
(To be filled by the Office)
(TO BE FILLED BY PARENT IN BLOCK LETTERS AND SENT ALONGWITH APPLICATION FORM)
1.
Name of the boy in full _______________________________________________________
2.
Father / Guardian’s Name_____________________________________________________
3.
Class for which admission is sought – (VI / IX) ______
4.
Correspondence Address :-
P
5.
4. Date of Birth _____/____/__ _ ____
Latest Passport size
photo to be pasted
and attested by the
Head of the institution
where the student is
presently studying.
I
N
Signature of the candidate
SAINIK SCHOOL GHORAKHAL WILL ALLOT EXAMINATION
CENTRE, ROLL NUMBER AND SEND HALL TICKET TO THE
CANDIDATE FOR APPEARING IN ENTRANCE EXAMINATION
Signature of the Issuing Officer
Sainik School Ghorakhal, Nainital
----------------------------------------------------------------------------------------------------------------------------
IDENTIFICATION FORM
FOR ENTRANCE EXAMINATION 2015-16
SAINIK SCHOOL GHORAKHAL, NAINITAL, UTTARAKHAND - 263156
Centre of Examination ___________________________________ Roll No _______/GK
(To be filled by Office)
(TO BE FILLED BY THE PARENT IN BLOCK LETTERS AND SENT ALONGWITH APPLICATION
FORM)
1.
Name of the boy in full
_________________________________
2.
Father’s/Guardian’s Name ___________________________________
3.
Class for which admission is sought - (VI / IX)
4.
Date of birth
5.
Signature of the candidate
________
______/______/________
SAINIK SCHOOL GHORAKHAL WILL ALLOT
EXAMINATION CENTRE, ROLL NUMBER AND RETAIN
IT FOR OFFICIAL USE
Latest Passport size
photo to be pasted
and attested by the
Head of the institution
where the student is
presently studying.
Signature of the Issuing Officer
Sainik School Ghorakhal, Nainital
-4-
SAINIK SCHOOL GHORAKHAL, NAINITAL, UTTARAKHAND - 263156
INSTRUCTIONS FOR THE SESSION 2015-16
Please read the following instructions carefully before filling up the Application Form
1.
Sainik School Ghorakhal, Nainital is one amongst the 25 Sainik Schools administered by the Sainik
Schools Society, an autonomous body functioning under Ministry of Defence. These schools were
established with the primary aim of preparing boys for entry into Defence Services through National
Defence Academy, Khadakwasla and to bring public school education within the reach of common people.
2.
Vacancies (Approx)
For Class VI - 60
and
For Class IX – 20
3.
Reservation 67% for Domicile of Uttarakhand and 33% for all Other States & Union Territories.
Out of total vacancies, 15% of the seats are reserved for SC, 7.5% for ST categories and 25% of the
remaining seats in each category for children of Defence service personnel and ex-servicemen.
4.
Date of birth for 2015-16 Applications are invited as per the given format from boys born
between dates given as under for the academic year 2015-16, for appearing in All India Sainik Schools
Entrance Examination to be held on 04th Jan 2015 :(a)
(b)
For Class VI :
For Class IX :
02 July 2004 to 01 July 2005 (both dates inclusive)
02 July 2001 to 01 July 2002 (both dates inclusive)
Note For admission to class IX the boy should be studying in Class VIII in a recognised school.
5.
Registration Fee (Non-Refundable) Registration Fee as under will be remitted to the school by
depositing at any SBI Branch through Challan Form attached with the Application Form. After depositing
the fee in the SBI Bank School Copy of Challan Form will be sent alongwith the Application Form and
Applicant copy of Challan Form will be retained by the candidate for future reference :(a)
(b)
General / Defence Category
Scheduled Caste / Scheduled Tribes Category
-
Rs
Rs
600/450/-.
Note :- REGISTRATION FEE ONCE PAID WILL NOT BE REFUNDED UNDER ANY CIRCUMSTANCES.
Cheques, Bank Draft, Indian Postal Orders, Pay Orders etc will not be accepted by the School.
6.
Scheme of Written Examination :(i)
Examination comprises of two papers namely Mathematics & Language and Intelligence
Test of V class standard for entry to VI class. The medium of Entrance Examination for
class VI will be in Hindi or English
(ii)
Two papers namely Mathematics & Science and English & Social Studies of VIII class
standard for entry to IX class. The medium of Entrance Examination for class IX shall be in
English only.
7.
Examination Centres Subject to availability of sufficient candidates, written examination Centres
will be at Almora, Bareilly, Dehradun, Ghorakhal, Gorakhpur, Kotdwar, Lucknow, Pithoragarh,
Roorkee, Srinagar (Garhwal), and Rudrapur (Udham Singh Nagar). Allotment of examination Centre
will be at the discretion of the school.
8.
Last Date for submission of Application Form Applications completed in all respects alongwith
Hall Ticket, Identification Form & Challan School Copy towards payment of Registration Fee must reach
the �Principal, Sainik School Ghorakhal, PO : Ghorakhal, Distt. Nainital, Uttarakhand, PIN - 263156
on or before 06th Dec 2014 (Saturday). Incomplete applications will be rejected and no communication
will be entertained in this respect. REGISTRATION FEE ONCE PAID IS NOT REFUNDABLE UNDER
ANY CIRCUMSTANCES.
9.
Date of Entrance Examination All India Sainik Schools Entrance Examination will be held on
04thJan 2015 (Sunday) at the centres given above at para No 7 (except Sainik School Nagrota, J&K).
10.
Fee
Total Fee including boarding, lodging and other charges is approximately Rs. 90,000/- for
the year 2015-16. Fee may be increased as per Sainik Schools Society existing rules.
……… 5
-
5 -
11.
Scholarship Scholarships are granted by the Government of Uttarakhand for the students of
Uttarakhand domicile, based on Parent’s Income & Merit. Boys who are admitted against the 25% quota
reserved for children of Defence service personnel/ex-servicemen including those of Uttarakhand domicile
are eligible for a limited number of scholarships granted by Ministry of Defence. However, diet subsidy is
provided for all Uttarakhand domicile boys including Defence Category children. In addition, all the boys
admitted except the Day Scholars (Staff Children) are provided with some financial assistance by Ministry of
Defence. Continuation of Scholarship once granted is subject to income/rank of parents, discipline and
academic performance of cadets.
12.
Repeater not allowed A boy can appear only once in the Entrance Examination for a particular
class for admission in Sainik Schools. For all disputes the legal jurisdiction will be at Nainital only.
13.
Application Form can also be downloaded from official website of the school www.ssghorakhal.org.
14.
List of the Sainik Schools
S.N
(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
(j)
Sainik Schools
Amaravathinagar,Tamil Nadu
Ambikapur Chattisgarh
Balachadi, Gujarat
Bhubaneshwar, Odisa
Bijapur, Karnataka
Chittorgarh, Rajasthan
Ghorakhal, Nainital, UK
Goalpara, Assam
Gopalganj, Bihar
S.N
(k)
(m)
(n)
(o)
(p)
(q)
(r)
(s)
(t)
Sainik Schools
Imphal, Manipur
Kapurthala, Punjab
Kazahakootam, Kerala
Kodagu, Karnataka
Korukonda, Andhra Pradesh
Kalikiri, Andhra Pradesh
Kunjpura, Haryana
Nagrota, J&K
Nalanda, Bihar
S.N
(u)
(v)
(w)
(x)
(y)
(z)
(aa)
Sainik Schools
Pungalwa, Nagaland
Purulia, West Bengal
Rewa, Madhya Pradesh
Rewari, Haryana
Satara, Maharastra
Sujanpur Tira, Himanchal
Tilaiya, Jharkhand
15
Courier services are not available from Nainital/Haldwani to Sainik School Ghorakhal and school will
not be responsible for Application Form sent by Courier service. PLEASE SEND ALL MAIL BY POST/
SPEED POST ONLY.
16
Detailed marks list will be supplied after 31 May 2015 to all the parents/legal guardians. All
parents/guardians are requested to send a self addressed envelope affixed postage worth Rs 22/- for
sending the Marks by Registered post alongwith the Application Form. If the self addressed envelope with
postage stamps of Rs 22/- not found attached alongwith the Application Form, the marks will be sent by
ordinary post and school will not be responsible for non-receipt or for any delay in delivery of mark sheet.
Copy of the answer sheet will not be provided.
17
One box each to be left blank after First Name and Middle Name & Last Name in the Application
Form at Serial No 9 to 12 and in Hall Ticket at Serial No 4 respectively.
18
Parents are requested to fill the APPLICATION FORM ONLY FOR BOYS AND NOT FOR GIRLS.
Principal
Sainik School Ghorakhal,
PO : Ghorakhal
Distt. Nainital, Uttarakhand – 263156
website : www.ssghorakhal.org
Note :- For any query you may contact school office on telephone No 05942 – 220051 & Mobile
9411107817 between 0900 hrs to 1200 hrs &1500 hrs to 1700 hrs (except Saturdays, Sundays
and holidays).
*********
……….. 6
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Applicant Copy
School Copy
STATE BANK OF INDIA
CHALLAN FOR REMITTANCE OF REGISTRATION
FEE FOR SAINIK SCHOOL GHORAKHAL
ENTRANCE EXAMINATION FOR SESSION 2015-16
STATE BANK OF INDIA
CHALLAN FOR REMITTANCE OF REGISTRATION FEE
FOR SAINIK SCHOOL GHORAKHAL
ENTRANCE EXAMINATION FOR SESSION 2015-16
POWER JYOTI ACCOUNT NO: 34061675992
AT SBI BHOWALI (CODE NO 01352)
POWER JYOTI ACCOUNT NO: 34061675992
AT SBI BHOWALI (CODE NO 01352)
1. Details of the Applicant (to be filled by the applicant)
Bank Copy
STATE BANK OF INDIA
CHALLAN FOR REMITTANCE OF REGISTRATION FEE
FOR SAINIK SCHOOL GHORAKHAL
ENTRANCE EXAMINATION FOR SESSION 2015-16
POWER JYOTI ACCOUNT NO: 34061675992
AT SBI BHOWALI
(CODE NO 01352)
1. Details of the Applicant (to be filled by the applicant)
1. Details of the Applicant (to be filled by the applicant)
Name of Applicant (boy) __________________________________
Name of Applicant (boy) _________________________________
Name of Applicant (boy) ________________________________
Date of Birth ___________________________________________
Date of Birth __________________________________________
Date of Birth _________________________________________
Father’s/ Mother’s Name__________________________________
Father’s/ Mother’s Name_________________________________
Father’s/ Mother’s Name________________________________
Class appearing (VI / IX)
Class appearing (VI / IX)
Class appearing (VI / IX)
Category (Please Tick)
_________________
General/ Defence / SC/ST
Category (Please Tick)
_________________
General/ Defence / SC/ST
:
_________________
Category (Please Tick) : General/ Defence / SC/ST
2. Depositing Branch Name SBI ___________________________
2. Depositing Branch Name _____________________________
2. Depositing Branch Name ____________________________
3. Branch Code No
3. Branch Code No
3. Branch Code No
4. JOURNAL NO.(to be filled by the Bank)
4. JOURNAL NO.(to be filled by the Bank)
4. JOURNAL NO.(to be filled by the Bank)
5. Fee Details :-
5. Fee Details :-
5. Fee Details :Rs
Rs
Rs
Application Fee
Application Fee
Application Fee
Bank Commission
Bank Commission
Bank Commission
Total
Total
Total
Rupees _______________________________________ Only.
6. Date of Deposit ___________________
Signature of the Applicant
Signature of the authorised
official with Branch Seal
Rupees ______________________________________ Only.
6. Date of Deposit ___________________
Signature of the Applicant
Signature of the authorised
official with Branch Seal
Rupees _______________________________________ Only.
6. Date of Deposit ___________________
Signature of the Applicant
Signature of the authorised
official with Branch Seal
Important instructions :-
Important instructions :-
Important instructions :-
(a)
Candidate should send SCHOOL COPY of this challan
along with their application form to SCHOOL & keep
applicant copy of this challan form for future reference
with him.
(a) Candidate should send SCHOOL COPY of this challan
along with their application form to SCHOOL & keep
applicant copy of this challan form for future reference
with him.
(a) Candidate should send SCHOOL COPY of this challan
along with their application form to SCHOOL & keep
applicant copy of this challan form for future reference
with him.
(b) Candidate should ensure that the Journal No. is filled in
by bank for this payment
(b) Candidate should ensure that the Journal No. is filled in
by bank for this payment
(b) Candidate should ensure that the Journal No. is filled in
by bank for this payment
(c) Fee for (General/Defence is Rs 600/-) & (SC/ST Rs 450/-)
(c) Fee for (General/Defence is Rs 600/-) &(SC/ST Rs 450/-)
(c) Fee for (General/Defence is Rs 600/-) &(SC/ST Rs 450/-)
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