Student Information:-
FORM NO:
ACADEMIC YEAR:
CLASS:
DATE:
First Name *
Middle Name
Last Name *
Date Of Birth *
Blood Group *
Gender
Religion *
Nationality *
Aadhar Card / Voter Card No *
1st Language*
2nd Language*
Mother Tongue*
STUDENT TYPE*
Mailing Address:-
Address *
Pin No *
City *
State *
Country *
Telephone [Res]
Mobile No [DND NOT ACTIVED]*
E-Mail Id *
Distance From School [In km]
Permanent Address [if same mailing address to click] 
Address *
Pin No *
City *
State *
Country *
Telephone [Res]
Information about Father:-
Father's Name *
Father's Date Of Birth
Father's Qualification *
Board / University
Nationality *
Profession *
Organization
Designation
Annual Income *
Office Address
Office Phone
Fax
Mobile No
E-Mail Id
Information about Mother:-
Mother's Name *
Mother's Date Of Birth
Mother's Qualification *
Board / University
Nationality *
Profession *
Organization
Designation
Annual Income *
Office Address
Office Phone
Fax
Mobile No
E-Mail Id
Guardian Information [other than parent] :-
Guardian's Name
Relation­ with ­Candidate
Address
Pin No
City
State
Country
Mobile
Own Sister/Sisters already studying in MHS
Produce Original and self attested photocopies of documents to support the above information(ID card/Fee Book)
No. of Sister
Sister's Code
Sister's Name
Class & Section
Additional Information about Parents :-
Are you an ex­-student of MHS ?
Year Of Passing
Student's Photo
MAX SIZE 60KB
Father's Photo
MAX SIZE 60KB
Mother's Photo
MAX SIZE 60KB
Guardian's Photo
MAX SIZE 60KB
 
Declaration/Undertaking
I understand that this registration form is only a request for admission without any obligation on the part of the school authorities to admit my child.
I understand that any sort of canvassing in the form of offering donation or reference will lead to disqualification of my ward's admission procedure.
I agree to abide by the rules and regulations of the school. I understand that these rules and regulations including the structure of school fees, may be modified and amended from time to time.
 
Do you give permission for moral instruction, Christian in nature ?
 
Do you give permission for medical checkup from time to time conducted by the school?
 
For Christian Students:­
I agree to allow my ward to participate all religious /church related activities that the school may organise from time to time. This regulation also applies when activities take place out of the usual school hours and outside the school premises.
I certify that the information furnished in this form is true to the best of my knowledge.
Signature of Parent/Guardian:____________________
IMPORTANT INFORMATION
 
MOUNT HERMON SCHOOL is committed towards all round development of its students. In today’s extremely competitive world, our students are often irrationally subjected to extreme conditions of stress, strain and mental trauma. The reason for this may be peer pressure, high expectation of parents, exposure to wrong information, which in turn, may be due to the unavailability of the accurate information and the absence of a patient and understanding advisor. Our Student Counsellor is always available to help our students. Parent counselling too plays a very significant role. Parents need to be supportive and attend all individual and group counselling sessions as and when required.
 
It is compulsory for every student to take part in extra­ curricular activities (Annual Concert, Annual Sports, Exhibition and other events) held in or outside the school premises. This regulation is also applicable to such activities which take place beyond usual school hours.
 
Should programmes like workshops, seminars or similar other activities be organized and conducted, all concerned students must compulsorily attend, even if the programmes take place outside the school premises and / or after school hours.
 
A minimum of 75 % attendance is to be maintained.
 
Fees paid during admission are non ­refundable and further request in this regard will not be entertained.
 
(ACCEPTANCE OF THE APPLICATION FORM DOES NOT GUARANTEE ADMISSION)
DECLARATION & ACCEPTANCE
 
We accept and uphold all rules and regulations of MOUNT HERMON SCHOOL for the all round development of my daughter
 
Father's Name:_____________________
Signature:_______________________
Mother's Name:_____________________
Signature:_______________________
 
The submission of the Application Form or completing the admission process and thereafter appearing for interaction does not guarantee admission. The school reserves the sole right to take the final decision regarding all admissions and the same shall be considered as final and binding on all applicants.
 
 
Residence Proof
 
Medical Certificate
 
Income Proof
 
Birth Certificate
 
Last year's Mark Sheet
 
Choice Of Meals:-
VEG ITEM
NONVEG ITEM
EGG
FISH
CHIKEN
MUTTON
BEEF
PORK
MEDICAL REPORT
HEALTH RECORD
(This certificate must be filled in and signed by the parent or guardian. If incomplete or inaccurate information is given this is liable to be regarded essay breach of contract and will cancel admission.)
Pupil's name in full (block letters, surname underlined) Boy or girlDate and year of birth Boarder or Day scholar Name and address of parent or guardianTelephoneemail
1. Has The Pupil had
Chickenpox? If So, give date
Diphtheria? If So, give date
Measles? If So, give date
German Measles? If So, give date
Mumps? If So, give date
Whooping cough? If So, give date
Typhoid fever? If So, give date
Rheumatic fever? If So, give date
Dysentery? If So, give date
T. B.? Amoebic or Bacalary? If So, give date
Any other infectious disease? If so what? Please give dates
2. Has the pupil been successfully :
a. Vaccinated against smallpox ? If So, When
b. re-vaccinated against smallpox? If So, When
c. Inoculated against diphtheria? If So, When
d. Inoculated against whooping cough? If So, When
e. Inoculated against typhoid? If So, When
f. Inoculated against cholera? If So, When
g. Inoculated against tuberculosis? If So, When
h. Inoculated against tuberculosis? If So, When
h. Inoculated against polio? If So, When
i. Inoculated against tetanus? If So, When
j. Inoculated against any other disease? If So, When
Please give dates
(Measures a, b, c, d, e, f, g, are compulsory and should be performed before the pupil enters school. A medical certificate testifying that this measures have been taken Mast accompany this from.if this measures are not taken carried out before the pupil enters School The school medical officers will have the right to take steps to carry them out without any further reference to the parent or guardian. It is understood that the signature of the parent to this blank gives permission for such action)
3. Do you have your permission for your child to have polio inoculation?
4. Has the pupil : had this? if so, when? been ruptured? if so when? Has any discharge from the ear? if so, when?
5. Is the pupil to any special from of lines e. g bed wetting?
6. Has the pupil had any surgical operations? If so give particulars
7. Does the pupil suffer from any ailment, or constitutional pecufanty affecting the general Health site hearing etc.?
8. Does the pupil suffer from worms? if so What kind (round worms, leap worms, hook worms, thread worms )?
9. Are the teeth in good order?
10. Is the pupil in your opinion in all respects for ordinary school life?
11.i hearby undertake to inform the school of any illness contact with infectious disease, which occurs at any time after this date before pupil enters, or while subsequently, he/she is on leave from school
12. In case of emergency I hereby give permission for the principal or his authorised agent to give legal and official consent for any operation or Medical treatment my child may have to undergo
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