— Achieve » Inspire «Succeed Buextanortt o Asian International School (Affiliated to CBSE, New Delhi, Affiliation Number-2430166, School Code - $6130) New Korolah, NH-6, Alampur, Howrah - 711 302, West Bengal, India [Link] : up ADMISSIONS 2017-18, Registration Number TET a r TTTIITT TT stupenr pata ForM Er ae Registration) a =, ‘Afecrecent receipto. |_| | | 1} dateofregisvation[ | | 1 | | | Gow on Use only Block letters. Please provide all details without leaving any blanks. Candidate 9 hema, ae = First Name Middle Name Last Name ‘Admission sought in Class _ Date of Birth ___ — Gender: [| FL Place of Birth _ eae Primary Contact information for communication (All information shall be provided to Primary Contact only) Contact Person's Name _ Relationship with the student: Address __ cy Country __ Primary Contact Number _ - Mobile No. Previous School / Montessori Details WotherTongue —- Nationality i Name of the School __ Religion _ cote: sc Ct CO) Address: oc [_] General Pete Canta ciry aa = Category: Generall—_] staft[—_] StaffName _ Country __ — --—Pin Code __ Staff Name of the Principal_ Searantive [apn ea} Legal Guardian (single parents selected* Last class Attended --—-—-—- — Father Moth ania nowe Board __ Medium of Instruction, 2nd Language (WinaBengalifAnpiable for candidotes rom cass Kilt Class 0) Second Language ___ __Third Language __ seltangease (HindBengaliSonkrvForegn Language) Please attach the following documents (Self attested) Applicable for candidates from Class Vito Class Vil) [Birth certificate [Previous Class Report Card [Photograph of the student [_]MR. [7 Taddress Proof (Jimmunisation Card Last Academic performance record (Please put % Marks) for students seeking admission in Ill to Class XI alee" lish | 2ndLanguage | Mathematics | Science | Social Studies VS Othersne — —— Qualification, FirstName Middle Name LastName Year of Passing _ Name of the College/University/Insttution _ Professional Qualification (ifany) _ Residential Address _ Phone _ Nationality _ Religion__ —Caste S¢[—]st{Jo8c{ |General] Mother Tongue__ Work Details (Y) Occupation Type: Service[] Govt{] Pve[) Busines: Professional{~] Others |] Organisation Name Designation __ _ Annual Income _ Office Address _ Office Contact Number _ Email id Qualification_ FirstName Middle Name ferocent Year of Passing _ Name of the College/University/Institution ____ Colour oe Professional Quali f of Mother ssional Qualification (ifany) _ ee Residential Address _ Mobile __ + Nationality _ Caste SC[~]ST!]OBC| |General] Mother Tongue_ Stil Work Detalls(¥) Occupation Type: Service|] Gove|_| Pvt[] Business[~] Professional{-] Others [~] Organisation Name Designation __ Annual Income Office Address _ Office Contact Number ‘Associated with [Please ( ¥“) the areas where parents (both father and mother) can contribute to school] [J muste — [“Jacademic [sports [Tcommunity Programme [social skits [E] Medical | Medaver [JHRTaining [—Paintingy | [CareerCounseing/ PublicSpeaking i QO oer ‘Sculpture. [eke Oo 0 Details of Siblings [re Regn No i i a __----__parentof. a have read the SchoolS rules and regulations and hereby agree to abide by the sama. All the above mentioned details provided by me/us are ‘tue in all respect. n case of discrepancy with the facts, the school authority reserves the right to cancel the Registration form as well as ‘the admission ofthe child. also hereby agree to abide by the school rule that the school reserves the right to Issue compulsory transfer _certifcate to the child for ay act ofndiscipline.| have read and fully understood these conditions and declarations. Signature of Father >> Signature of Mother —>Achieve «Inspire «Succeed Asian International School (Affiliated to CBSE, New Delhi, Affiliation Number-24301 |66, School Code - $6130) New Korolah, NH-6, Alampur, Howrah - 711 302, West Bengal, India y [Link] ADMISSIONS 2017-18 FEE STRUCTURE free roa rea ‘Admissions Fees (One Time) 245,000 45,000 35,000 ‘Security Deposit (One Time) 35,000 5,000 5000 ‘Administrative Charges a i 10,000 Total One (One Time) 350,000 50,000 50,000 Session Fee (Annual) 5000 %5,500 ®7,000 ‘Maintenance (Annual) 3000 33,500 3500 Development Fee (Annual) 4000 4000 4,000 Activity Fee (Annual) 2.500 72,500 2,500 Miscellaneous Fee (Annual) 7,000 1000 1,000 Tuition Fee (Quarterly) 6,000 7500 10,500 Lab Fees(Science Students oni) - = 31,000 [oral 71,500 374,000 $79,500 + Fees have to be deposited on a quarterly bass, + The fees are not inclusive of school uniform, accessories, books, stationery and transport (GENERAL NFORMATION Gado Sener m [Wey Fy ive warn Studion eveyrona TRANSPORT FACILITIES 1. Pik up and crop services wil be available or students troughoutKllata, Howrah and Hooshy 2. formation garding the precise routes and pickup locations wil be provided oparents/guatalns before the commencement of the academic session. 3. Cost ill depend on the stance covered by the school veil. Distance wise ib ae aregven onthe school webste and are also available with the transport authorities ste school campus, Application Form & Prospectus av ° ‘School Campus 56/2 Hazra Road, 3rd Floor, Kolkata few Korolah, PS Domjur, NH~6, 700 019, West Be i, INDIA. Howrah - 711 302, West Bengal, ‘Selected Branches (List of branches sie a me ie earch at the following locations DFC BANK — ns T Landmark - Near Hazra Law College Contact Person - Ms Shilpi Karan Landmark - Near Alampur Contact Person - Mr Binod Shaw Contact Person - Mi Balbhav Das See Phone Numbers: + 91 33 2669 0097, +91 33 2669 0098, +91 9674277777 info@aiseduorg, _____Website-wwwaiseduorg PEER SUBMISSION OF APPLICATION 1. STUDENT DATA FORM, ‘ADMIT CARD 1. Ad 2 ADMIT CARD 2. STATIONERY FORTHETEST (Class &abeve) | 2. Doctor's Cethicate 3. Medical Form | 3. Allorginal Documents submited during | 3. Fees 4. BIRTH CERTIFICATE (Photocopy) depositing the Application. (Fr Verification) 5. Previous lass Report Card Photocopy) | 6 2Photographs of Student 17 {[Link] Proof & Adress Proof munication Card spees Two hunderd and Fifty Only) ton Processing fee [APPLICATION FORM CHARGE - %500/ (Rupees FivAchieve «Inspire «Succeed Asian International School | (Affiliated to CBSE, New Delhi, Affiliation Number-2430166, School Code - 56130) J New Korolah, NH-6, Alampur, Howrah - 711 302, West Bengal, India [Link] MEDICAL FORM up eee wou Use only block letters; please provide all details without leaving any blanks. a pate of th TT TTT see M[] FL] sce T] —peaponsze DDMMYYYY Name __. Class_ Weight: :____ (cm) Blood Group: Power (in case of spectacles): L/E RE ‘Medical History: (Please give the detalls of any serious illness / operation, contagious/infectious diseases, your child might have suffered / undergone) 1. Diseases suffered: {like Measles, Mumps, Chicken Pox, Jaundice, Tuberculosis, Epilepsy, Swine Flu (H1 N1) etc} ie ee “Disease ie Year Details of Vaccination: (Please attach photography of immunisation.) [ tstDose [2nd Dose Dip 7OPV MMR Typhoid se Hepatitis A Hepatitis Chicken Pox Uwe hereby give/ do not give/ shall write back in 10 days, my consent for vaccination of my child for () Typhoid (i) Chicken, Pox (li) Hepatitis A (iv) Hepatitis B (v) Any other Vaccine. (Strike all whichever is not applicable) (Signature of Parent / Guardian) _ ‘Name (in capital letters) __«Achieve «Inspire + sueceed Asian International School | (Affiliated to CBSE, New Delhi, Affiliation Number-2430166, School Code- 56130) New Korolah, NH-6, Alampur, Howrah - 711 302, West Bengal, India y [Link] oe, uD DOCTOR'S CERTIFICATE (EE Please have this form filled by your child's Paediatrician / General Physician and submit the form at the school office along with the admission form. This is to certify that | have examined the following student and his/her health details are mentioned below. _ Gender: M[____ Ophthalmic problems: _ Fans) Dental problems:____ Grany) Orthopaedic problems: __ any) Respiratory problems: _. eng) OP Skin problems: _ ran Allergic Fron Epilepsy: Metabolism (obesity ete): Heart problems: any) Any other problems: Any other problems: Doctor's Signature:____