FORM FOR ADMISSION IN THE DESTITUTE  CHILDREN’S HOME

(To be filled in by guardian or child)

1. Name of children:
    (In block letters)
   
    
2. Date of Birth:
   
   
    
3. Father’s Name:
   
   
    
4. Guardian’s name and
   full address:
   
   
    
5. Annual income &
   Occupation of the guardian:
   (income certificate to be enclosed)                                           
   
   
    
6. Whether permanent resident of Sikkim
   (A relevant document be enclosed):                                            (Yes / No)
   
   
    
7. (a)        Orphan / Semi orphan:
   
   (b)        In case of single parent
               (tick against the provision applicable)
                                                                                            Father deed / Mother deed
8. (a)        In case of Student, state the
               class with year of session:
    
   (b)        Name of School:
   
    
9. Religion:
   
    
10. A brief history of the child/home background:
    
     

To the best of my belief and knowledge the information given above are true. In case any information is found to be incorrect the admission of the child in the Destitute Children’s Home may be cancelled.

 

SIGNATURE OR THUMB IMPRESSION OF THE GUARDIAN