POST BOX -140
CHURCH COLONY 
WOKHA,NAGALAND
       797111
FORM NO:  ..................

AFFILIATED TO NBSE                         NO.NBE-22/Ex-Recog-HS/2020-21        SCHOOL REG. NO. PR/5304/’19

          ADMISSION FORM CLASS 11                            (Arts)                                      SESSION 2020-2021

(IN BLOCK LETTERS)
NAME OF PUPIL
DATE OF BIRTH
SEX 
NAME OF FATHER
NAME OF MOTHER
TRIBE/COMMUNITY
RELIGION
FULL PRESENT ADDRESS
NAME OF THE INSTITUTE LAST ATTENED
CLASS IN WHICH THE APPLICANT WAS LAST READING
Percentage Obtained
Date of Admission .................
Admission No. .................

LIBEMO  MEMORIAL HIGHER SECONDARY SCHOOL

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