BOARD OF SCHOOL EDUCATION HUBLI, KARNATAKA

206, Upper Ground Floor, IT Park, Deshpande Nagar,

Hubballi, Karnataka 580029
www.bseh.ac.in [email protected]

Secondary School Admission Form

Name of Student’s:

Father’s Name:

Mother’s Name:

Date of Birth:

Examination:

Name of the Aflated Sc hool:

Regular/Private:

Subject Taken: 1) 2) 3)

4) 5) 6)

Optional Subject:

(Signature of Student)
(Signature of Principal) with Office Seal

FOR OFFICE USE ONLY

Certied tha t S/O, D/O

Eligible for admission in I received admission fee sum

of Rs. By DD No. Cash on dated

Sig. of Controller Regional Centre (Signature of Cashier)

with Seal
 BOARD OF SCHOOL EDUCATION HUBLI,KARNATAKA
206, Upper Ground Floor, IT park, Deshpande nagar,
Hubballi, Karnataka 580029
www.bseh.ac.in [email protected]

SELF DECLARATION

I...................................................................................................... D/S/O/................................................................

R/O...............................................................................................................................................................................

F/O................................................................................................................................................................................

do hereby solemnly affirm and declare as under:

1) that I am the permanent resident of the above said address.

2) that the Date of Birth of my child is.......................................................

3) that he/she wants to appear in secondary / sr.secondary class for the year................

from Board of school education hubli

through...............................................................................................................................................................

4) that i fully understand of the rules, regulations and legal status of the

Board of School Education Hubli, Karnataka

Deponent

Declaration
I solemnly declare that the particulars given above are correct to the best of my knowledge
I also understand that if the informa�on provided by me in the form is incorrect, incomplete or false, my
applica�on will be rejected upon detec�on at any stage.
Deponent
 BOARD OF SCHOOL EDUCATION HUBLI,KARNATAKA
206, Upper Ground floor, IT Park Deshpande nagar,
Hubballi, Karnataka 580029
www.bseh.ac.in [email protected]

Examination Form
Name of Candidate

Father’s Name Photo

Photo by
attested
Mother’s Name attested by
Principal
Principal
Guardian’s Name

Postal Address

(Signature of the Student)

Distt.

State Pincode No:

E-Mail

Date of Birth: Telephone No:

Nationality: Native Language:

Previous Qualification: Medium of Study:

Course Applied for:

Subject Taken: 1) 2) 3)

4) 5) 6)

8th, Xth Board Examination:-

1) Year of passing: Roll No:

3) Name of Board/Council:

4) Total amount of fee paid:

Examination Centre alloted:

Name of the affiliated School:

Enclosures:
1) Date of Birth Certificate
2) Residence Proof / Aadhar Card Copy
3) 4 Miniature Size Photograph
4) Photocopy of Previous Qualification
5) Transfer Certificate/ Migration Certificate Sig & Stamp Sig. of the Principal
of the Principal
 BOARD OFSCHOOL EDUCATION HUBLI, KARNATAKA
206, Upper Ground Floor, IT park, Deshpande nagar,
Hubballi, Karnataka 580029
www.bseh.ac.in [email protected]

[email protected]

ADMIT CARD
Secondary Examination 20___20___
Roll No:
Name of Student:
Mother’s Name: Photo
Father’s Name attested by
Date of Birth: Principal
Name of the Study Centre/School:

Signature (Signature of the Student)

Controller of Examination

BOARD OF SCHOOL EDUCATION HUBLI, KARNATAKA

STATEMENT OF EXAMINATION ATTENDANCE

Secondary Examination 20___ 20___

Roll No:
Name of Student:
Mother’s Name:
Photo
Father’s Name attested by
Date of Birth: Principal
Name of the Study Centre/School:

Signature (Signature of the Student)

Controller of Examination

S.No. Date Subjects Signature of the Student Signature of the Invigilator

1.
2.
3.
4.
5.
6.
7.
8.
Please send the statement of attendance with the answer sheets of the examination