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Students Self Information Reports Form

This document contains a student self-information report form for St. Mary's Convent Sr. Sec. School in Amroha. The form requests information such as the student's class, name, gender, address, parent and guardian details, admission date, previous academic performance, and whether the student receives certain scholarships or benefits. Notes at the bottom provide clarification on types of ration cards in India and advise bringing a photocopy of the student's Aadhaar card along with the completed form.

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246 views

Students Self Information Reports Form

This document contains a student self-information report form for St. Mary's Convent Sr. Sec. School in Amroha. The form requests information such as the student's class, name, gender, address, parent and guardian details, admission date, previous academic performance, and whether the student receives certain scholarships or benefits. Notes at the bottom provide clarification on types of ration cards in India and advise bringing a photocopy of the student's Aadhaar card along with the completed form.

Uploaded by

FUTURE POINT
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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St. Mary’s Convent Sr. Sec.

School, Amroha
STUDENTS SELF INFORMATION REPORTS FORM (KINDLY FILL ALL RESPONSES IN CAPITAL LETTERS)

Class
Section
Roll No
Name of the student
Gender
DOB (DD-MM-YYYY)
Mother Name
Father Name
Guardian Name (Optional)
Aadhaar Number of Child
Student Name (As per Aadhaar)
Present Address
PIN CODE
MOBILE Number (Active)
ALTERNATE MOBILE NUMBER (Optional)
EMAIL ID (STUDENT/PARAENT/GAURDIAN)
(optional)
Mother Tongue
Social category (ST, SC, OBC, GEN)
Minority Group (Sikh, Muslims, Christian, Jain,
Paris, Others
Is BPL Beneficiary? Grabi rakha sy neechey wala
rasan card (Yes or No)
Whether Antodaya Anna Youjna (AAY)
Beneficiary? (Yes or No)
Belongs to EWS/DISADVANTAGED GROUP?
(Yes or No)
Is CWSN? (Yes or No) NO
CWSN IMPAIRMENT TYPE (Yes or No) NO
CHILD IS INDIAN NATIONAL? (Yes-1, No-2) 1
CHILD IS OUT-OF-SCHOOL-CHILD? (Yes-1, No-2)
When the child is mainstreamed?
Admission Number
ADMISSION DATE (DD-MM-YYYY)
STUDENT STREAM (For higher secondary only)
PREVIOUS ACADEMIC YEAR SCHOOLING STATUS 1
CLASS STUDIES IN PREVIOUS ACADEMIC YEAR
ADMITED/ENROLLED UNDER RTE/EWS?
(for private unaided only)
APPEARED FOR EXAM IN PREVIOUS CLASS 1
(1-Appeared, 2- Not Appeared)
RESULT FOR PREVIOUS EXAM
MARKS % OF PREVIOUS EXAM
CLASS ATTENDED DAYS (Previous Year)
Facility Received Free Uniform (Yes-1, No-2) 2
Facility Received Free Text Book (Yes-1, No-2) 2
Received Central Scholarship (Yes-1, No-2) 2
Name of Central Scholarship (provide code only)
Received State Scholarship (Yes-1, No-2) 2
Received Other Scholarship (Yes-1, No-2) 2
Scholarship Amount
Facility provided to the CWSN
Specific Learning Disability (SLD) (Yes-1, No-2) 2
Type of Specific Learning Disability (SLD)
Autism Spectrum Disorder (Yes-1, No-2) 2
Attention Deficit Hyperactive Disorder (ADHD) (Yes-1, No-2) 2
Involved in extra Curricular activity? (Yes-1, No-2) 2
Vocational Courses (Yes-1, No-2) 2
Trade/Sector ID
Job Role ID
Appeared for Examination in Previous Class for 3
Vocational Subject

कृपया सभी उत्तर बड़े अक्षरों में भरें


राशन कार्ड क़े बाऱे म़े -
गरीबी रे खा से नीचे (BPL) राशन कार्ड जो गरीबी रे खा से नीचे रहने वाले पररवारों को जारी ककए जाते है। इस कार्ड का रं ग लाल होता है।
अंत्योदय अन्न योजना (AAY) राशन कार्ड जो "गरीब से गरीब" पररवारों को जारी ककए जाये है। यह कार्ड पील़े रं ग में ममलता है।

Note – Bring photo copy of Aadhaar card along with this form. If you do not
understand any column, please leave it.

नोट- इस फॉमड के साथ आधार कार्ड की फोटो कॉपी लाए। यदद कोई कॉलम समझ मे
नहीं आता है तो कृप्याकर उसे छोड़ दे ।

Thank you

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