BIRLA VIDYA MANDIR, NAINITAL (INDIA)

(Sarala Birla Group of Schools)

REGISTRATION FORM
Code No.___________

Centre opted for Admission Test : __________________________________

Category : Gen. SC/ST OBC Nationality______________

Name of the Pupil______________________________________________ Affix
passport size
Date of Birth__________________________________________________ photograph
Father’s Name & Qualification______________________________________ of
the child
Mother’s Name & Qualification______________________________________
Occupation of Father/Mother_______________________________________
(Mention designation in case of service and specify the type in case of business)
Residential Address of Parent/Guardian_____________________________________________
___________________________________________________________________________
___________________________________________________________________________
Telephone Number : Code_________ Office__________Residence_________Mobile__________
Fax______________E-mail__________________________________________
Class in which seeking admission___________________________________________________
Class in which studying at present__________________Medium of instruction_________________
Name & Address of the school where studying at present________________________________
___________________________________________________________________________
(Please attach latest progress report and Character Certificate from the Principal of the present school)___________
Co-curricular interests of the child_____________Final Exam. Passed_____________________
Name(s), and class of brother(s) studying in Birla Vidya Mandir, Nainital_____________________
____________________________________________________________________________
____________________________________________________________________________
Whether any family member has studied in Birla Vidya Mandir, Nainital (Please give details)
Name Year of passing out Relationship with the child
_________________ _____________________ ________________________
_________________ _____________________ ________________________
Name, address & contact numbers of two responsible persons known to parent/guardian :
1. Name______________________________ 2. Name______________________________
Address____________________________ Address ____________________________
____________________________ ____________________________
Mobile No __________________________ Mobile No __________________________
I have read the rules of Birla Vidya Mandir and agree to abide by them. If, inspite of the precautions
taken by the school, any mishap, accident or injury takes place during the period of my ward's stay in
the school or if and when he joins a tour, excursion or camp, I will not hold the institution or any
member of its staff wholly or partially responsible for it.

I understand that all disputes shall fall within the jurisdiction of Nainital courts only.

The cost of Prospectus of Rs. ................... and the Registration Fee of Rs. ............... is being remitted
through Bank Draft No._____________dated__________ drawn on_______________________
(Name of the bank)

Date :_______________ Signature of Parent

Note :
1. The registration fee of Rs. ................... is payable by Account Payee Bank Draft only in favour of
Birla Vidya Mandir, Nainital.
2. The registration fee is neither refundable nor transferable to another year.
3. In case a boy is put on the waiting list, admission is not guaranteed.

FOR THE USE OF THE OFFICE

Registration fee received vide Receipt No._______________________ Dated________________

Sl. No.______________________________Registration_______________________________

ACCOUNTANT

Admitted in class_________________ Boy No._________________House__________________

PRINCIPAL

Dues Realised Rs.__________________Receipt No.________________Dated______________

ACCOUNTS DEPARTMENT
 Appendix ‘B’
Undertaking by the Parent/Guardian
I understand that my son/ward is granted admission to Birla Vidya Mandir, Nainital on the following
terms and conditions :
1. That I will submit the T.C. of the previous school within 15 days of his joining the school, failing
which the Principal will have the right to cancel the admission and send my son / ward home.
2. That I will deposit the fee in full before the beginning of each term. The account of personal
expenses may be sent to me when completed.
If the instalments of school fee are not paid by me within due dates, a penalty of Rs. 100/- for the
first day and that of Rs. 50/- per day for each subsequent day will be levied.
If the instalments of school fee and penalty due are not paid by me within 30 days, I may be asked
to withdraw my son / ward.
3. That I have studied the leave rules of the institution. I understand that all festivals are celebrated
by the boys in the school and no home leave is permissible on religious functions. In addition to
the journey days, only two days leave for attending the marriages of real sisters and brothers or
parents’ brothers or sisters and to offer condolence to immediate relations is permissible. Re-
quest for leave for attending the marriage should be accompanied by an invitation card. No leave
is granted to the boy unless applied for directly to the Principal. Overnight leave for staying in
town with parents (not with brothers, sisters or other relations) will be asked for in writing only on
the second and fourth Saturdays.
4. That no food parcel will be sent to the my son / ward.
5. That my son / ward will not be given any cash at all. All the money required for him will be sent
directly to the school office.
6. That if my son / ward leaves the school campus without permission, the school authorities may
lodge an F.I.R. with the local police station and I will have no right to question and raise objections
to this action. The school will not be responsible for any mishap in such circumstances.
7. That my son / ward may be removed from the school for indulging in the following acts of
indiscipline :
a. Non-payment of school dues
b. Using unfair means in any examination
c. Consistently unsatisfactory performance in academics
d. Immorality
e. Grave insubordination
f. Stealing or extortion of money or other items from other boys
g. Contempt of authority
h. Breaking bounds
i. Damaging school property
j. Any word or action likely to undermine the reputation of the institution
k. Bullying, assaulting and ragging in any form
I. Keeping mobile phone, CD player, electric kettle, heater, MP3 player etc.
8. That the school does not hold any responsibility in cases of sickness or accidents. This applies
also to all the accidents which may occur in the science laboratories, gymnastics, boxing,
workshops, rock- climbing, mountaineering, swimming, educational tours, play grounds,
classrooms, hostels or on journeys to and from the school.
9. That the parents/visitors are not allowed to meet their wards during school hours. They can
visit them only second and fourth Saturdays at 1:00 p.m. onwards, after signing the visitor’s
register.
10. That parents / visitors are not allowed to visit the dormitories.
11. That leave will not be granted on the pretext of illness of relatives, including that of parents,
except under very special circumstances.
12. That the promotion to the next class is not automatic. It will be granted at the end of the annual
examination in accordance with the school promotion policy which may vary from time to
time.
13. That the number of seats in class XI being limited, I clearly understand that the admission of
my son/ward is valid upto class X only and that he will have to seek fresh admission to class
XI, which is selective and subject to the discretion of the Principal. It will depend on the general
conduct and academic performance of my son / ward during his stay in the school.
14. That the school will do its best to provide medical aid, but will not be held responsible for any
accident or mishap.
15. That the boys are encouraged to put their difficulties to the teachers but there is no provision
for private tuition. Boys not making satisfactory progress in academics will have to be
withdrawn, if so advised by the school authorities.
16. That if it is possible to make arrangements for professional training, additional amount shall
be applicable.
17. That the school does not take responsibility for escorting boys to and from their homes.
18. That my son / ward shall never travel alone to and from home.
19. That taking all the examinations conducted by the school is compulsory.
20. That if my son / ward indulges in any act of indiscipline, or is found disobeying the instructions
of the Principal / House Masters / Teachers, he may be denied admission in the next session.

I understand that all disputes shall fall within the jurisdiction of Nainital courts only.

Date________________ (Signature of the Parent / Guardian)

Name of the Ward__________________

 BIRLA VIDYA MANDIR, NAINITAL
(Sarala Birla Group of Schools)

ENTRANCE EXAMINATION
ADMIT CARD

Registration No. Class Centre

Name_______________________________________________________
Affix your
Father’s Name_________________________________________________ passport size
photograph
(Same as in the
Address______________________________________________________ Registration form)

_________________________________________________________________

___________________________________________________________________________

Date of Examination_____________________________Time 10 a.m. to 1 p.m.

Note :
Please bring this admit card with you and hand it over to I/C ENTRANCE EXAMINATION on
demand.
Please reach the examination hall half an hour before the commencement of the examination.

ENTRANCE EXAMINATION I/C PRINCIPAL

 BIRLA VIDYA MANDIR, NAINITAL
(Sarala Birla Group of Schools)

UNDERTAKING
SWIMMING / ROCK CLIMBING
TREKKING / BOXING / GYMNASTICS
MARTIAL ARTS & OTHER GAMES & SPORTS

I shall be happy if my ward_______________________________________________________________

No.______________________, as per his desire & selection to participate in the above mentioned
activities and courses, is included in these, as and when conducted by the school. This may be treated
as my formal consent for the above activities / courses.

I agree to abide by the directions of the activity / course incharge and the authorities of Birla Vidya
Mandir, Nainital, at all times during the course of the training of my ward.

In case of any mishap, accident or injury, I shall not hold the school (Birla Vidya Mandir, Nainital) or
any member of its staff wholly or partially responsible for it.

I understand that all disputes shall fall within the jurisdiction of Nainital courts only.

Date :________________ (Signature of the Parent / Guardian)

Address __________________________

_________________________________

_________________________________

_________________________________

Telephone________________________