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Deaf Student Passport Application Form

The document is a student data collection form for schools, capturing essential information such as the student's name, gender, date of birth, parent's details, and social category. It also includes sections for identifying if the student belongs to economically weaker sections or has special needs. The form is intended for use by the School Education Department of the Government of West Bengal.

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skdamanilogin
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18 views1 page

Deaf Student Passport Application Form

The document is a student data collection form for schools, capturing essential information such as the student's name, gender, date of birth, parent's details, and social category. It also includes sections for identifying if the student belongs to economically weaker sections or has special needs. The form is intended for use by the School Education Department of the Government of West Bengal.

Uploaded by

skdamanilogin
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

STUDENT DCF

Name of the School


Affix Passport size
UDISE Code of School 1916. photograph of the
student
Student Code
(to be filled up by school after generation from BSP)

GENERAL INFORMATION OF STUDENT

FIRST MIDDLE LAST


Name of the Student*:

Gender: MALE FEMALE TRANSGENDER [Give (V)in the box/

Date of Birth*: D DM M YYYY


Mother's Name*:

Father's Name*:

Guardian's Namet:

Aadhaar No of Child:

Name of Student as PerAadhaar :

Mother Tongue of the Chiid*:

Social Category* (GENERAL,SC,ST,OBC-A,OBC-B)):


Religion*:
HINDU, MUSLIM, CHRISTIAN, SIKH, BUDDHIST, PARSI, JAIN, OTHERS)

Whether BPL beneficiary?* (Yes-1, No-2):


If Yes, then Whether Anthodia Anna Yojana (AAY) beneficiary? (Yes-1, No-2) :
If Yes, BPL No*.:

Whether belongs to Economically Weaker Section (EWS) / Disadvantaged Group*?


(Yes-1, No-2):
Whether CWSN*? (Yes-1, No-2) :

If Yes, Type of impairment*


(Type of Impairment -1-Blindness, 2-Low-Vision, 3-Hearing impairment, 4-Speech and Language,5-Locomotor Disability,
6-Mental ilness, 7-Specific Learning Disability (SLD)s, 8-Cerebral palsy, 9-Autism Spectrum Disorder (ASD), 10-Multiple
Disability incl. deaf, blindness, 11-Leprosy Cured students, 12-Dwafism, 13-Intellectual Disability, 14-Muscular
Dystrophy, 15-Chronic Neurological conditions, 16-Multiple Sclerosis, 17-Thalassemia, 18-Haemophilia, 19-Sickle Cell
disease, 20-Acid Attack victim, 21-Parkinson's disease)

If Specific Learning Disability (SLD), specify the type*:


(Dysgraphia-1, Dyscalculia-2, Dyslexia-3)
Page 1 of 8
[Link] School Education Department, Govt. West Bengal [Ver.:3.0; Release Date: 23.12.2022]

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