Rte Form

Price of Form: NIL ATOMIC ENERGY CENTRAL SCHOOL
Application Form for Admission under RTE Act-2009 to class -I

For the Academic Year 2022-23
Sl.No.2022/ Affix latest
photograph
Admission No. ________________ (For Office Use) RELIGION-____________ CASTE-________________
To
The Principal/Co-ordinating Principal SC ST EWS BPL OBC (NCL) CWSN
ATOMIC ENERGY CENTRAL SCHOOL No ____ (Tick (√) in appropriate box)
______________________Centre
Sir/Madam,
I request you to admit my son/daughter/ward to class I, under the provision of RTE Act-2009. The required particulars are
given below:
1. Name of the pupil in full Surname First Name Middle Name
(in BLOCK letters)
1a Name proposed by parents to be entered into

school records. (It will not be changed later.)
In BLOCK letters.
2 Date of birth In figures In words
DD MM YYYY
3 Place of birth Village: Taluka:
Dist.: State:
4 Age as on 31st March 2022
___Days___Months___Years Gender Male / Female
5 a) Father’s full name in block letters a)
b) Mother’s full name in block letters b)
6 Parents Official address with designation
(father and/or mother)
7
Complete Residential address with address proof
8 Aadhaar Number / Sl.no of child in the ration card
and blood group of child.
9 Annual income of the parents (Both father & Mother)
10 Telephone No. (if any)and e-mail

Office: ___________________ Residence: ___________________
Mobile: __________________ e-mail: __________________
Creche: _______________ Emergency contact no. __________

11 Name of the home town of the parents as per official
record of their employment. Village: __________________
Taluka: __________________ Dist. _____________________
Nearest Rly. Stn. __________________

Contd...2/-
: 2 :
ATOMIC ENERGY CENTRAL SCHOOL

12 Mother tongue of the child
13 Whether the pupil belongs to Yes / No
SC/ST/EWS/BPL/OBC(NCL)/CWSN If yes, enclose relevant certificates.
Please specify Caste & Category and enclose a
copy of the caste certificate in the name of the child.
14 Whether the pupil belongs to economically weaker Yes / No
section (EWS). The certificate issued should not be If yes, enclose relevant certificates.
older than 6 months as on 1st April of the year of
admission.
15 If the pupil is CWSN (Child With Special Needs) Yes / No
Disability percentage should be more than 40%. If yes, enclose relevant certificates.
Attach certificate issued by competent authority.
16 Whether the pupil belongs to BPL category (Specify Yes / No
valid BPL score to authenticate BPL category as on If yes, BPL score
1st April 2022)
17 Whether the pupil is studying in any school Yes/No
presently. If yes, give the following particulars
School_____________________________ class :_____
18 Distance of residence from the school to which Name of the school Order of Priority Distance from
admission is sought in the order of priority given by (Parent is expected to give order
of priority between 1 to 6)
residence to school.
the parent. (Please see the note given at the end of
this table at #).
19 Identification Mark ( any two ) 1)
2)
# Note: Parents are required to write order of choice of schools at point no.19 in the above table like AECS-1, AECS-2, AECS-3 etc.
DECLARATION BY PARENT/GUARDIAN
a) I hereby declare that the information given about my son/daughter/ward (name of the child)
________________________________ furnished by me is true and correct and that I will not demand any change in the date
of birth mentioned at serial 2 at a future date.
b) I am also aware that if the information furnished above is found to be false or incorrect at any stage, the admission will be
cancelled and the child withdrawn from the school.
c) I shall abide by the rules of the AEC schools & AEES from time to time.
Date: ______________ Signature of the Parent / Guardian

Name:
Contd...3/-
: 3 :
ATOMIC ENERGY CENTRAL SCHOOL

Documents to be enclosed with the duly filled in application form for admission:
1. Certificate of proof of age in the form of birth certificate issued by the authority competent to register births. This will include
certificates from Notified Area Council/ Municipality/ Municipality Corporation extract about the date of birth from records of
Village Panchayat endorsed under the seal and signature of the Revenue/Panchayat officer of the concerned area.
2. A certificate that the child belongs to the Scheduled Caste/ Scheduled Tribe/ EWS/OBC (Non-Creamy Layer)/ BPL/ CWSN,
wherever applicable, issued by the competent authority in concerned State Government/ Union Government. The certificate
as applicable in respect of either of the parents may be accepted initially, for the purpose of admission, if this certificate is not
available for the child. However, the certificate in respect of the child has to be submitted within a period of 03 Months from
the date of admission.
3. A Certificate from the civil surgeon/rehabilitation centre or any other competent authority defined by the Government of India
certifying the child to be handicapped, wherever applicable. In case, where the handicap of the child can be visually seen by
the principal, the child may be accepted as handicapped even without a certificate. However, the parent may be advised to
obtain the relevant certificate from the competent authority and submit the same to the school.
4. Proof of residence (essential) and distance from the school:
Note: A self-declaration in writing from the parent about distance of the residence from the school in which admission is sought
may also be accepted to this effect.
5. Aadhar card of parents.
6. Income proof of the parents issued by the employer concerned or Revenue authorities
2022 /
Sr. No. RECEIPT
AECS- ___________ received an admission form from Master/Miss__________________________________ son/daughter of
_____________________________________ for admission to Class ___________.
I have personally verified copies of the required documents/enclosures which are attached herewith.
Date: (Dealing Assistant)

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Price of Form: NIL ATOMIC ENERGY CENTRAL SCHOOL

Application Form for Admission under RTE Act-2009 to class -I

Admission No. (For Office Use) RELIGION- CASTE-

1a Name proposed by parents to be entered into

3 Place of birth Village: Taluka:

10 Telephone No. (if any)and e-mail

Mobile: e-mail:

Creche: _____ Emergency contact no.

Taluka: Dist. ___

Nearest Rly. Stn. __________________

ATOMIC ENERGY CENTRAL SCHOOL

19 Identification Mark ( any two ) 1)

Date: ______________ Signature of the Parent / Guardian

ATOMIC ENERGY CENTRAL SCHOOL

AECS- _ received an admission form from Master/Miss________________________ son/daughter of

___________________________ for admission to Class _.

Date: (Dealing Assistant)

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