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Application Form For Admission to Class: NEET - Repeaters Girls Residential -2025
Personal Information
Application for class :
NEET Repeaters Girls Residential
V
VI
VII
VIII
IX
X
XI - Science
XI -Science with NEET UG Girls
XI- Science with JEE Girls
XI -Science with NEET UG Boys
XI- Science with JEE Boys
XII- Science
XII -Science with NEET UG Girls
XII- Science with JEE Girls
XII -Science with NEET UG Boys
XII- Science with JEE Boys
NEET - Repeaters Boys Residential
NEET Repeaters Girls Residential
NEET Repeaters Boys non-Residential
NEET - Repeaters Girls non-Residential
JEE - Repeaters Boys Residential
JEE Repeaters Girls Residential
JEE Repeaters Boys non-Residential
JEE- Repeaters Girls non-Residential
Academic year :
2025
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
Exam. Center Name
*
SNH Mumtaz Public School
Student Name
*
Date of Birth
*
Mobile No
*
WhatsApp No
*
Email ID
Mother tongue
Gender
Male
Female
Aadhaar number
Blood group
A+
A-
B+
B-
AB+
AB-
O+
O-
Religion
Category
General
OBC-A
OBC-B
SC
ST
Others
PWD
Yes
No
Nationality
Father's Name
*
Father's Qualification
Father's Occupation
Father's Mobile No
Father's Whatsapp No
Father's Monthly Income
Mother's Name
Mother's Qualification
Mother's occupation
Mother's Monthly Income
Guardian’s name (Except Parents)
Guardian’s occupation
Relationship With Student
Guardian’s mobile
Mother's mobile
Place Of Birth
My father is not my guardian
Correspondence Address and Contact Details
Village/Town/City
Post Office
Police Station
Block
Pincode
District
Bankura
Bardhaman
Birbhum
Cooch Behar
Darjiling
East Midnapore
Hooghly
Howrah
Jalpaiguri
Kolkata
Malda
Murshidabad
Nadia
North 24 Parganas
North Dinajpur
Puruliya
South 24 Parganas
South Dinajpur
West Midnapore
State
ANDAMAN & NICOBAR ISLANDS
ANDHRA PRADESH
ARUNACHAL PRADESH
ASSAM
BIHAR
CHANDIGARH
CHATTISGARH
DADRA & NAGAR HAVELI
DAMAN & DIU
DELHI
GOA
GUJARAT
HARYANA
HIMACHAL PRADESH
JAMMU & KASHMIR
JHARKHAND
KARNATAKA
KERALA
LAKSHADWEEP
MADHYA PRADESH
MAHARASHTRA
MANIPUR
MEGHALAYA
MIZORAM
NAGALAND
NULL
ODISHA
PONDICHERRY
PUNJAB
RAJASTHAN
SIKKIM
statename
TAMIL NADU
TELANGANA
TRIPURA
UTTAR PRADESH
UTTARAKHAND
WEST BENGAL
Educational Information Of Students
Last Attended Class
School
School Address
Mission/Hostel
Board
Total marks
Marks obtain
Percentage
L.Science/Biology
Physical Science / Physics
Chemistry
Math
English
Fees Slab
Full Fees
Half Fees
2/3 Of Total
Orphan
Reference
Extra Curricular Activities (If Any)
Activities 1
Activities 2
Permanent Address
Same as present address
Village
Post office
Block
Police station
Pincode
District
Bankura
Bardhaman
Birbhum
Cooch Behar
Darjiling
East Midnapore
Hooghly
Howrah
Jalpaiguri
Kolkata
Malda
Murshidabad
Nadia
North 24 Parganas
North Dinajpur
Puruliya
South 24 Parganas
South Dinajpur
West Midnapore
State
ANDAMAN & NICOBAR ISLANDS
ANDHRA PRADESH
ARUNACHAL PRADESH
ASSAM
BIHAR
CHANDIGARH
CHATTISGARH
DADRA & NAGAR HAVELI
DAMAN & DIU
DELHI
GOA
GUJARAT
HARYANA
HIMACHAL PRADESH
JAMMU & KASHMIR
JHARKHAND
KARNATAKA
KERALA
LAKSHADWEEP
MADHYA PRADESH
MAHARASHTRA
MANIPUR
MEGHALAYA
MIZORAM
NAGALAND
NULL
ODISHA
PONDICHERRY
PUNJAB
RAJASTHAN
SIKKIM
statename
TAMIL NADU
TELANGANA
TRIPURA
UTTAR PRADESH
UTTARAKHAND
WEST BENGAL
Age
Orphan
Identification mark
Rights on child
First language
What wants to be
Hobbies
Admission date
Admission category
Need a hostel
No
Yes
Student type
Day Scholars
Day Boarding
Hosteler
Previous class grade
Father's Aisj Member
No
Yes
Father id no
Mother's aisj member
No
Yes
Mother's id no
Guardian’s aisj member
No
Yes
Guardian’s id no
Permanent nationality
Annual family income
Bank account number
Ifsc code
Bank name
Bank branch
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