Date of Birth :
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Form No:................
Pilgrim Higher Secondary , Dimapur
ONLINE REGISTRATION PRO FORMA FOR CLASS - 11 ( ARTS)
* Incomplete Form will not be accepted.
Pupil`s Name in BLOCK: Mr/Miss :
Father`s Name in BLOCK :
Mother"s Name in BLOCK :
Aadhar number:  
Community: 
Religion:  
Identification Mark (As per HSLC/CBSE/NON NBSE Admit Card ):
Name of the School Last Attended : 
Examination last appeared: Year of Examination:
HSLC/CBSE/NON NBSE Total Marks:  
Percentage:
NBSE Registration No. ( For class XI Repeater ):
Seeking Admission as:   
Bus Facility required:            Address:




Father`s 
Mother`s
Guardain`s
Emergency Contact Number :
Click to Upload Files Total Uploaded:
Documents to be enclosed after admission: 
   a. For Nagaland Board of School Education (NBSE). 
        i. Passport – 2 Nos of recent passport size photo to be pasted in admission form and Pro forma.
       ii. Photocopy Admit Card of HSLC Examination – 3 Nos.
       iii. Photocopy of Mark Sheet cum Provisional Certificate of HSLC Examination – 3 Nos.
       iv. PCR/CRSH Book duly entered (NBSE Candidates). 
   b. For Other Boards (NON NBSE).
        i. Passport – 2 Nos of recent passport size photo to be pasted in admission form and Pro forma.
       ii. Photocopy of Mark sheet of HSLC Examination – 3 Nos.
       iii. Migration Certificate (Original & duly Sealed & Signed by District Education Officer (DEO).
       iv. Photocopy of HSLC Provisional/Pass Certificate – 3 Nos. 
       v. Transfer Certificate (Original & duly Sealed & Signed by District Education Officer (DEO). 
       vi. Filled attached application format for Eligibility Certificate.

E-Mail : Father`s:     Mother`s:
Scheme of Studies : 
Compulsary : (i) English 
Elective : (i) Alt. English ( ii) Education (iii)  History (iv) Political science 
Optional :

(As per HSLC/CBSE/NON NBSE Admit Card )

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