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BOSTON INTERNATIONAL SCHOOLNo.534, T.T.K.Road, Alwarpet, Chennai !"

E#$ail%in&o'(o)ton#)*hool.*o$+ate%Ad$i))ion N$(er%

Required Enclosures:

!. State$ent o& -ar) o& Hal& # /earl0 or 1inal E2a$ination. Tran)&er Certi*ate3. Atte)ted *op0 o& Birth Certi*ate

DECLARATION

APPLICATION FORMPRIMARY – IGCSE (Standard X)

GCE-AS & A2-LEVEL (Standards XI and XII)

! Na$e o& the Candidate1ir)t, -iddle, La)t6

Se2 Che* Appropriate6 -ale 1e$ale

3 +ate o& Birth ++7--7////6

4 Nationalit0 and Reli8ion

5 -other Ton8e

9 Ca)te : Co$$nit0

; Na$e o& the <arent) or=ardian6

1ather-other=ardian

" O**pation : -onthl0 In*o$eo& <arent) 7 =ardian6

> Re)idential Addre)) : Conta*tIn&or$ation <hone : E$ail6

!?

O@*e Addre)) : Conta*tIn&or$ation <hone : E$ail6

!

!

La)t S*hool Attended

Na$e, Addre)) : Conta*tIn&or$ation6

!

 Tran)&er Certi*ate No. : +ate

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I 7 e a8ree to a(ide (0 all the rle) and re8lation) o& the in)tittion &ra$ed (0the -ana8e$ent &ro$ ti$e to ti$e and I will not *lai$ an0 re&nd o& the a$ontpaid to the in)tittion.

I 7 e here(0 de*lare that the in&or$ation 8ien in the appli*ation &or$ i) *orre*tand a**rate

I 7 e a8ree that the &ee) on*e paid will not (e ad)ted 7 re&nded to $e 7 ).

Si8natre o& the Stdent Si8natre o& the <arent

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