APPLICATION FOR ADMISSION INTO CHILDREN HOMES 1. Name of the Child in full : (Block letters) 2. Date of birth in Christian : 3. Father's Name in full address : 4. Name of guardian (if father is alive with full address & his relationship to the applicant : 5. Occupation of father or guardian : and annual income from occupation and other sources 6. Income certificate to issued an : Officer of the Revenue Dept., not less than Deputy Tasildar or Inspector of Police or any Gazetted Officer should to furnished. 7. Caste and relation (in the case of : Backward class Scheduled Tribe and Scheduled Caste the name the Caste certificate produce from the Village Munsiff of a other Revenue Officer or Dist.Social Welfare Officer 8. General Educational Qualification : (state the examination passed enclose a transfer certificate 9. Remarks for seeking admission Place : Date : Signature of the Father / Guardian UNDERTAKING (in case of Girl) I hereby undertaking that I shall not take away my daughter (onward) from the institution until they attains the age of 18 years and completion of her a secondary school education. Signature of the Father / Guardian
