PROVISIONAL ADMISSION CONFIRMATION FORM
RESIDENTIAL : 2026-27
Important Points, Read Before Filling-in Form:
1. Please use blue ball pen and write in CAPITAL letters only.
Please paste a passport size
(4 cm x 3 cm)
photograph here.
Do NOT staple.
1. Full Name (Surname first) (In English) :
` Full Name (Surname first) (In Marathi) :
2. a) Father's or Guardian's Name :
b) Relationship to the applicant :
Father
c) Mother's Maiden Name :
3. Profession of Father/Guardian :
(If in service, his designation and office) :
4. Date of Birth :
5. Permanent Home Address :
5. Permanent Home Address :
5. Permanent Home Address :
PIN:
6. Mobile No. :
Whatsapp No. :
7. Parent's Email ID :
Fees :
Rs. 200,000.00
Discount, if any :
Rs. 0.00
Reason for the discount :
---
Final fees after discount :
Rs. 200,000.00
PAYMENT SCHEDULE
Option - One Instalment
Two Instalment
Three Instalment
✓
| Instalments |
I |
II |
III |
| Amount Rs. |
80,000.00 |
60,000.00 |
60,000.00 |
Due Date of Payment
(1st Instalment on the date of admission confirmation)
|
19-09-2026 |
07-08-2026 |
07-12-2026 |
| Parent's Signature |
|
|
|
PRO Name :
Admission Cell
Sign. : ________________________
UNDERTAKING
I, (Name)
parent / guardian of (Name of the student)
of class 5th (CBSE)
have been explained the fees rules / terms regarding the fees in the language I understand and I hereby undertake the responsibility to pay the fees as per the above schedule. Failing which I will be liable to pay late fees as per the school policy.
मी (नाव)
पालक (विद्यार्थ्याचे नाव)
इयत्ता 5th (CBSE)
निर्धारित केलेल्या नियमाप्रमाणे मला समजेल अशा भाषेत फिस संबंधी नियम / अटी स्पष्ट केल्या आहेत आणि मी फीस भरण्याची जबाबदारी स्वीकारत आहे. शाळेच्या नियमानुसार फिस भरण्यास उशीर झाल्यास विलंब शुल्क (लेट फिस) भरण्यास मी पात्र राहील.
Sig of Student
Sig of Parent/ Guardian
PLACE : Chhatrapati Sambhajinagar
APPROVAL FOR THE ADMISSION
Approved/ Not Approved
DATE :
19 / 09 / 2026
Sig of the CAO
[ For Office Use Only ]