SPECIAL PRESCHOOL FOR THE DEAF
SOCIAL WELFARE DIVISION
SOCIAL WELFARE DEPARTMENT
GOVERNMENT OF SIKKIM

Admission Form (to be filled by guardian of child)

PHOTOGRAPH
OF THE
APPLICANT
  1. Name of Student:-_______________________________________________________
     
  2. Date of Birth:-__________________________________________________________
     
  3. Name of Father:-________________________________________________________

                  Mother:-_______________________________________________________
     
  4. Address:-_____________________________________________________________
               
                  ______________________________________________________________
     
  5. Occupation of Father:-____________________________________________________
     
  6. Occupation of Mother:-___________________________________________________
     
  7. Family income per annum:-_________________________________________________
     
  8. Details  of other children in the Family
     
    SL. NO. NAME AGE F/M EDUCATIONAL
    QUALIFICATION     		IF DISABLED NATURE OF DISABILITY
    HH/OH/VH/MR/MH
               
               
               
               

         The above information given by me is true to the best of my knowledge. In case any information is found to be incorrect the admission of my child in the Special School for the Deaf may be cancelled.

Signature of parent / guardian with full name

_________________________________

_________________________________

Document to be submitted along with this form.

  1. Four recent passport size photograph of child.

  2. Income Certificate or Salary Certificate of parents.

  3. Sikkim Subject/Identification Certificate.

  4. Disability Certificate issued by ENT Specialist.

  5. Transfer Certificate of School last attended.

  6. Birth Certificate of Child.