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    Student Academic Management System (SAMS) S PDF

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    Satyajit Patra
    Priyanka Karan has submitted a Common Application Form to seek admission to higher secondary school for the 2020-21 academic year in Odisha. She provides details of her 10th board exam such as attending the BSE, Odisha in 2020 and scoring a total of 382 marks with a B2 grade. She is seeking admission to the Science stream and has listed Seemanta Higher Secondary School as her first preference and included her choice of compulsory and elective subjects. She has undertaken to abide by the school and hostel rules and not participate in ragging activities.

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    Student Academic Management System (SAMS) S PDF

    Uploaded by

    Satyajit Patra
    245 views2 pages
    Priyanka Karan has submitted a Common Application Form to seek admission to higher secondary school for the 2020-21 academic year in Odisha. She provides details of her 10th board exam such as attending the BSE, Odisha in 2020 and scoring a total of 382 marks with a B2 grade. She is seeking admission to the Science stream and has listed Seemanta Higher Secondary School as her first preference and included her choice of compulsory and elective subjects. She has undertaken to abide by the school and hostel rules and not participate in ragging activities.

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    Student Academic Management System (SAMS)s.pdf

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    Priyanka Karan has submitted a Common Application Form to seek admission to higher secondary school for the 2020-21 academic year in Odisha. She provides details of her 10th board exam such as attending the BSE, Odisha in 2020 and scoring a total of 382 marks with a B2 grade. She is seeking admission to the Science stream and has listed Seemanta Higher Secondary School as her first preference and included her choice of compulsory and elective subjects. She has undertaken to abide by the school and hostel rules and not participate in ragging activities.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    245 views2 pages

    Student Academic Management System (SAMS) S PDF

    Uploaded by

    Satyajit Patra
    Priyanka Karan has submitted a Common Application Form to seek admission to higher secondary school for the 2020-21 academic year in Odisha. She provides details of her 10th board exam such as attending the BSE, Odisha in 2020 and scoring a total of 382 marks with a B2 grade. She is seeking admission to the Science stream and has listed Seemanta Higher Secondary School as her first preference and included her choice of compulsory and elective subjects. She has undertaken to abide by the school and hostel rules and not participate in ragging activities.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Common Application Form 20J2378289

    Admission to Higher Secondary School [Erstwhile Junior College] 


    Academic Session (2020-21)
    Department of School & Mass Education, Government of Odisha XI
    Saturday, Sep 19, 2020 07:30:15 PM
    Note:-This CAF Applicant Copy is required to submit at the time of admission.

    1. 10th Board Details Name of the Examination Board Year of Passing Exam Type Roll Number
    (As in admit Card) BSE, ODISHA 2020 Annual 261CD0138

    2. Applicant's Name PRIYANKA KARAN

    3. Father's Name ASHWINI KUMAR KARAN

    4. Mother's Name MADHUMITA KARAN

    5. Personal Details Blood Group   Sex   Religion   Date of Birth  


      FEMALE   HINDU   08-Oct-2004  
    Nationality Mother Tongue Aadhaar No. Guardian Mobile No. Orphan
    INDIAN ODIA 809821514612 9777821402 No

         

    6. Address for Correspondence

    a. State ODISHA   b. District MAYURBHANJ c. Block / ULB SARASKANA

    d. Address AT-BANARATILA,RATILA,PS-JHARPOKHARIA e. PIN Code 757051

    f. Telephone No.     g. Mobile No. 9777821402 h. e-Mail

    7. Reservation Details
    a. Schedule Tribe Schedule Caste Other Backward Class Socially and Educationally Backward Classes General
    No No No Yes No

    b. Persons with Disabilities No Ex-Service Man No Serving Defence Personnel No Children of Martyrs No

    8. Weightage Details

    a.  NCC   b.   Scout & Guide   c.   Sports

    NCC (A) No NCC (C) No Rajya Puraskar(RP) No President Recognition(PR) No State No National No International No

    9. Details of Mark/Grade Secured in 10th Board Examination


    a. Mark/Grade secured in each subject in Maximum Mark Total Mark Secured English/SL Mathematics Science Social Science Grade
    10th Board Examination
      600   382   53   74   48   50   B2

    b. Have you passed 10th Board Exam


    No  
    Compartmentally ?

    10. Income Details of Parents

    a. Father's Occupation CULTIVATION


    b. Mother's Occupation HOME MAKER

    c. Annual Income of the Parents (Together)in Rs. OTHERS


    11 Record of educational institution last attended

    a. Name of the School SARATPAL HIGH SCHOOL, RATILA


    b. Location of the School RATILA

    c. District MAYURBHANJ d. Year of Joining 2018

    e. Year of Leaving 2020

    12 Option(s)/Choice(s) Details

    Option HSS Name Stream Compulsory Electives 4th Electives inorder of preference Hostel
    Option

    FIRST Seemanta Higher Secondary School, Science MIL Odia Physics,Chemistry,Mathematics Biology,Information Yes
    Jharpokharia Technology,Information Technology
    (Voc)

    SECOND Saratpal Higher Secondary School, Science MIL Odia Physics,Chemistry,Mathematics Biology,Information No
    Palvihar Technology,Computer Science

    THIRD Baigan Badia Higher Secondary School, Science MIL Odia Physics,Chemistry,Mathematics Biology,Information No
    Baiganbadia Technology,Horticulture

    FOURTH Baripada Higher Secondary School, Science MIL Odia Physics,Chemistry,Mathematics Biology,Mobile Yes
    Baripada Technology,Information Technology

    FIFTH Laxmi Kanta Higher Secondary School, Science MIL Odia Physics,Chemistry,Mathematics Biology,Information Technology Yes
    Bangriposi (Voc),Information Technology

    Payment Details

    Mode of Payment Payment Status Amount Paid Transaction No. Transaction Date

    ONLINE SUCCESS 200.00 7227858182901 29/08/2020

    UNDERTAKING
    I do hereby agree to abide by the rules of the HSS/Hostel. I undertake that should any indiscipline and disobedience instance of the rules laid down by the
    Government or any authority empowered by them in this regard or should conduct in the HSS is found not satisfactory, my name will automatically be removed
    from the HSS. I undertake that information furnished by me in this application is true and correct and i undertake that any wrong information furnished be me,
    detected afterwards will be treated as cognizable offence.

    I further undertake that i will not involve in any ragging activities in the HSS and hostel premises. I understand that criminal case will be filed against me if
    indulge in ragging
     
    I hereby fully endorse the undertaking made by our
    child / ward Submitted by me

    Signature or thumb impression of parents/ guardian Full Signature of Applicant


    Date   Place   Date   Place  
     
    Enclosures (Certified True Copy of the following documents would enclosed along with the CAF)
    Sl.# Documents

    1 One (1) self signed (on the front side) recent color passport size photograph to be affixed in the CAF (HSS Copy).

    2 True Copy of HSC Mark Sheets-cum-Provisional Certificate (or equivalent Board).

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