THE HINDU SENIOR SECONDARY

SCHOOL
(A Unit of Hindu Educational Organisation)
New no.169 Old No. 83, Big Street, Triplicane, Chennai 600 005, Phone:
28443312

APPLICATION FORM (LKG)

Registration No. (For Office use only)

1.

Name of the Pupil ( In BLOCK LETTERS)

2.

Sex:
Date of Birth :

Affix the
Latest
Passport Size
Photo of the
Student

Male / Female
a) In figures

3.
b) In words

4.

Whether the pupil belongs to Scheduled

Caste or Scheduled Tribe / BC / OBC (for
Statistical purpose only) (Xerox copy of
certificate to be attached.)

5.

Whether living with parent or guardian

Name of the Parent with Qualification
a) Father

6.

Occupation / Designation /Annual

Income
/Office Address & Phone No.
b) Mother

Occupation / Designation /Annual

Income
/Office Address & Phone No.
Name of the Guardian ( if living with
guardian)
7.

a) Residential Address
b) Occupation / Designation / office
Address &
Phone No.
(P.T.O)

Acknowledgment

Filled in Application received from

___________________________________________________________ on ______________
(Name of the pupil)
Registration No. ______________________ Class: __________________
Receivers
Signature
For
PRINCIPAL, H.S.S.SCHOOL

8.

Nationality and State to which the pupil

belongs

9.

Mother Tongue of Pupil and Home Town

10 Details of siblings studying in this

. institution (Own Brothers / Sisters only)

Name
Relationship:
Class

11
Other Relevant information , if any
.

Declaratio
I __________________________________________________________________________
do, hereby declare that the particulars given above are true. If any of the above
particulars are found not to be true, the admission may be cancelled. I also agree
that T.C. may be issued whenever either parent of the student makes a request for
withdrawal.

Affix the
Latest
Photograph
of Father /
Guardian

1.
2.
3.

4.

Affix the
Latest
Photograph
of Father /
Guardian

Signature of Father/ Mother/ Guardian :

Station:

Date:

NOT
E
To pay Rs.130/- at the time of registration.
Issue of the Application form or Registration does not guarantee allotment of seat or
admission to the class.
For admission to LKG the child must have completed 3 years but must be
below 4 years of age as on 31st March of the year of admission and for other
classes with an addition of one year for each class.
Birth Certificate in original to be submitted only at the time of admission. This will
not be returned.

5. Duly filled in Application form should be returned to the school office before 5.p.m.
of the last date announced for registration.
6. Refer School Notice Board for admission under RTE. (Use separate
application)

7. Documents to be submitted with the application

(i)
Xerox copy of Birth Certificate and Progress Report from the previous school
(Originals to be submitted at the time of admission)

Please check School Notice Board for selection list and admission
related notifications.
No individual intimation will be made.