ADMISSION STRICTLY FOR BOYS ONLY

Form No _____________ Roll No _____________/GK

(To be filled by the school) Category ____________
(To be filled by the school)

SAINIK SCHOOL GHORAKHAL, NAINITAL, UTTARAKHAND - 263156

APPLICATION FORM FOR ADMISSION : ACADEMIC YEAR 2011-12
READ INSTRUCTIONS CAREFULLY BEFORE FILLING UP THE APPLICATION FORM
FILL ALL COLUMNS IN LEGIBLE CAPITAL LETTERS USING A4 SIZE WHITE PAPER
1. Class for which admission is sought – VI / IX ______
Day Month Year
2. Date of Birth Latest Passport size
photo to be pasted
3. Name of the boy in Full (CAPITAL LETTERS ONLY) and attested by the
Head of the institution
where the student is
presently studying.
4. Father’s Full Name (CAPITAL LETTERS ONLY)

5. Mother’s Full Name (CAPITAL LETTERS ONLY) LAST DATE FOR

SUBMISSION OF
APPLICATION FORM
10 DEC 2010
6. Full Name of the Guardian (CAPITAL LETTERS ONLY) (If Parents are not alive) (FRIDAY)
EXAMINATION DATE
02 JAN 2011
(SUNDAY)
7. Nationality _______________ 8. State of Domicile (Parents) ______________
9.
) your category in the box - General
Please Tick (
Defence SC ST

(a) If you belong to SC/ST Category, please specify your Sub Caste/Tribe____________
(Attach photo copy of caste certificate issued by the competent authority)

(b) If you belong to DEFENCE Category, please furnish the following details :-
Whether serving Service Rank Date of Enrolment/ Date of Name of the
or Ex-service Number Commission Discharge Record Office
personnel

10. Occupation of Father / Mother/ Guardian ______________/______________/__________

(Government/ Private Service/Business/Farming etc. to be specified) _________________
11. Monthly Income from all sources Rs ______________
12. Address for Correspondence

P I N
13. Telephone No. with STD Code ____________________Mobile __________________________
e-mail ID if any _________________________
 -2-

14. Permanent Address

P I N

15. Choice of Examination Centre Ist ______________________________________

(Please see instruction Sl. No 7) IInd______________________________________
IIIrd______________________________________

16. Has your son/ward appeared in entrance examination earlier? If yes, please give the following details

Name of the centre Year Roll Number Class

17. Bank Draft No _______________________ dated ____ /_____/2010 Rs _________

(Name and address of issuing branch) ______________________________________
(DEMAND DRAFT IN FAVOUR OF PRINCIPAL, SAINIK SCHOOL GHORAKHAL PAYABLE AT
STATE BANK OF INDIA BHOWALI [BRANCH CODE 01352] TO BE DRAWN/MADE AT STATE
BANK OF INDIA ONLY)

18. a) The parents who are willing to admit their son/ward in other Sainik Schools as Full Fee Payee
Candidate in case he is qualified, but low in merit of Sainik School Ghorakhal list, are to give an
undertaking that they are willing to admit their son/ward as Full Fee Payee candidate in other Sainik
Schools.
Yes/No _____

b) If yes, give names of three choices of Sainik Schools in order of preference. (THIS WILL BE
CONSIDERED ONLY IF VACANCY EXISTS IN OTHER SAINIK SCHOOLS.) (PLEASE SEE
PAGE NO 5).

Choices :- (i) Sainik School ______________________________

(ii) Sainik School ______________________________
(iii) Sainik School ______________________________

DECLARATION BY PARENTS

I solemnly declare that the particulars furnished above are true and no information has been
concealed. In the event any of the above information found incorrect at any time, I have no objection for
removal of my son from the school and refund the scholarship amount if availed. Orders and Instructions
given/issued from time to time by the Principal will be binding on me.

Date _____/______/ 2010 _________________________________________

Signature and Name of the Father/Mother/Guardian
Place _________________

PLEASE ENSURE FOLLOWING

1. Application Form should be completed and filled-in all respects. Incomplete Application Form will be
summarily rejected.

2. Attach Hall Ticket & Identification Card. (Blank Form attached with this application at page No 3)
3. Name of the candidate alongwith father’s name to be written on the reverse of Demand Draft.
4. Attach Caste certificates, where ever applicable.
 -3-
HALL TICKET
SAINIK SCHOOL GHORAKHAL, NAINITAL, UTTARAKHAND - 263156
FOR ENTRANCE EXAMINATION 2011-12
(TO BE FILLED BY PARENT IN BLOCK LETTERS AND SEND ALONGWITH APPLICATION FORM)

Centre of Examination________________________________ Roll No ___________/GK

1. Name of the boy in full _____________________________________________________

2. Father / Guardian’s Name___________________________________________________

3. Class for which admission is sought- VI / IX ______ 4. Date of Birth ____/__ _ /_______

Correspondence Address Latest Passport size

photo to be pasted
and attested by the
Head of the institution
where the student is
presently studying.
P I N

Signature of the Boy

Signature of the Issuing Officer

SAINIK SCHOOL GHORAKHAL WILL ALLOT EXAMINATION Sainik School Ghorakhal, Nainital
CENTRE, ROLL NUMBER AND SEND HALL TICKET TO THE
CANDIDATE FOR APPEARING IN ENTRANCE EXAMINATION

IDENTIFICATION FORM
SAINIK SCHOOL GHORAKHAL, NAINITAL, UTTARAKHAND - 263156
(TO BE FILLED BY THE PARENT IN BLOCK LETTERS AND SENT ALONGWITH APPLICATION FORM)

Centre of Examination _________________________________ Roll No __________/GK

Name of the boy in full _________________________________ Latest Passport size

photo to be pasted
Father’s/Guardian’s Name ___________________________________ and attested by the
Head of the institution
Class for which admission is sought - VI / IX _____ where the student is
presently studying.
Date of birth ______/______/________

Signature of the Boy

SAINIK SCHOOL GHORAKHAL WILL ALLOT Signature of the Issuing Officer

EXAMINATION CENTRE, ROLL NUMBER Sainik School Ghorakhal, Nainital
AND RETAIN IT FOR OFFICIAL USE
 -4-
SAINIK SCHOOL GHORAKHAL, NAINITAL, UTTARAKHAND - 263156
INSTRUCTIONS
Please read the following instructions carefully before filling up the Application Form.
1. Left one column blank after First, Second and Surname.

2. Date of birth :- Applications are invited as per the given format from boys born between dates given as under for
the academic year 2011-12, for appearance in All India Sainik Schools Entrance Examination to be held on 02 Jan 2011 :-

(a) For Class VI 02 July 2000 to 01 July 2001 (both dates inclusive)
(b) For Class IX 02 July 1997 to 01 July 1998 (both dates inclusive)

3. Registration Fee :- Application has to be attached with a demand draft for Registration fee (non-refundable) as
under :-
(a) General / Defence Category - Rs 500/-.
(b) Scheduled Caste/Scheduled Tribes Category - Rs 350/-.

Note : The State Bank of India demand draft may please be made in favour of The Principal, Sainik School Ghorakhal, payable at
State Bank of India Bhowali Branch (Code No. 01352). Name of the candidate alongwith father’s name to be written on the reverse
of demand draft. Cheques, Indian Postal Oders, Pay Order etc are not acceptable by the School. Registration fee paid once will not
be refunded under any circumstances.

4. Sainik School Ghorakhal, Nainital is one amongst the 24 Sainik Schools administered by the Sainik Schools Society,
an autonomous body functioning under Ministry of Defence. These schools were established with the primary aim of preparing
boys for entry into Defence Services through National Defence Academy, Khadakwasla and to bring public school education
within the reach of common people.

5. Vacancies :- For class VI - 60 & for class IX - 30 (Tentative).

6. Reservation :- 67% for domicile of Uttarakhand and 33% for all other States & Union Territories. Out of total
vacancies, 15% of the seats are reserved for SC, 7.5% for ST categories and 25% of the remaining seats in each category for
children of Defence service personnel and ex-servicemen.

7. Examination Centres :- Subject to availability of sufficient candidates for the written examination centres will be
Almora, Bareilly, Dehradun, Ghorakhal, Ghorakhpur, Kotdwar, Lucknow, Pithoragarh, Roorkee, Srinagar (Garhwal),
and Udham Singh Nagar. Allotment of Examination centre will be at the discretion of the school.

8. Scheme of Written Examination :- Examination comprises of two papers namely Mathematics & Language and
Intelligence Test of V class standard for entry to VI class and two papers namely Mathematics & Science and English & Social
Studies of VIII class standard for entry to IX class. The medium of Entrance Examination for class VI will be in Hindi or English
but for class IX it shall be in English only.

9. Fee :- Total Fee including boarding and lodging and other charges is approximately Rs. 90,000/- for the year
2011-12. 10% of fee will be increased every year as per existing rules.

10. Scholarship :- Scholarships are granted by the Government of Uttarakhand for the students of Uttarakhand
domicile, based on Parent’s Income & Merit. Boys who are admitted against the 25% quota reserved for children of Defence
service personnel/ex-servicemen including those of Uttarakhand domicile are eligible for a limited number of scholarships
granted by Ministry of Defence. However, diet subsidy is provided for all Uttarakhand domicile boys including Defence
Category children. In addition, all the boys admitted except the Day Scholars are provided with some financial assistance by
Ministry of Defence. Continuation of Scholarship once granted is subject to income of parents, discipline and academic
performance of cadets.

11. Repeater not allowed :- A boy can appear only once in the Entrance Examination for a particular class for
admission in Sainik School except for Sainik School Nagrota. For all disputes the legal jurisdiction will be at Nainital only.

12. Last Date for submission of application forms :- Applications completed in all respects along with Hall Ticket,
Identification certificate & Demand Draft towards Registration Fee must reach the ‘Principal, Sainik School Ghorakhal,
PO : Ghorakhal, Distt- Nainital, Uttarakhand PIN - 263156 on or before 10 Dec 2010. Incomplete applications will be
rejected and no communication will be entertained in this respect. Registration fee once paid is not refundable under any
circumstances.

13. Application Form can also be downloaded from school’s website www.ssghorakhal.org.

14. Parents are requested to fill the Application Form only for boys not for girls. Courier services are not available from
Nainital/Haldwani to Sainik School Ghorakhal. Please send all mail by Post.

Principal
Sainik School Ghorakhal,
PO : Ghorakhal
Distt. Nainital, Uttarakhand – 263156
Telephone 05942-220051, 220045,
website : www.ssghorakhal.org
Query Timings : 0900 hrs to 1200 hrs,
1500 hrs to 1700 hrs (except Saturday)
 -5-

ADDRESSES OF ALL SAINIK SCHOOLS

Sl. Address Sl. Address

No No
1. Principal 13. Principal
Sainik School Purulia Sainik School Imphal
PO : Sainik School Purulia Post Box No 21
Distt. Purulia, West Bengal – 723101 Distt. Imphal, Manipur – 795001
2. Principal 14. Principal
Sainik School Kazhakootam Sainik School Punglwa
PO : Sainik School Via-Medziphema,
Distt. Thiruvananthapuram, Kerala - 695585 Distt - Peren, Nagaland – 797112
3. Principal 15. Principal
Sainik School Tilaiya Sainik School Kodagu
PO : Tilaiya Dam PO : Kudige
Distt : Koderma, Jharkhand - 825413 Distt. Kodagu, Karanataka – 571232
4. Principal 16. Principal
Sainik School Bijapur Sainik School Kunjpura
Distt. Bijapur, Karnataka -586102 Distt. Karnal, Haryana – 132023
5. Principal 17. Principal
Sainik School Chittorgarh Sainik School Amaravathinagar
Dist. Chittorgarh , Rajasthan – 321001 Distt. Coimbatore, Tamil Nadu – 642102
6. Principal 18. Principal
Sainik School Sujanpur Tira Sainik School Balachadi
Distt. Hamirpur, Himachal Pradesh - 176110 Distt. Jamnagar, Gujarat – 361230
7. Principal 19. Principal
Sainik School Satara Sainik School Nagrota
Distt. Satara, Maharastra – 451001 Distt. Nagrota, Jamu & Kashmir – 181221
8. Principal 20. Principal
Sainik School Kapurthala Sainik School Rewa
Distt. Kapurthala, Punjab – 144601 Distt. Rewa, Madhya Pradesh – 386001
9. Principal 21. Principal
Sainik School Korukonda Sainik School Rewari
PO Korukonda Vill. Gorthra Tappa Kheri, Sector - 4
Distt. Vizianagram, Andhra Pradesh 531241 Distt. Rewari, Haryana – 123401
10. Principal 22. Principal
Sainik School Gopalganj Sainik School Ambikarpur
PO : Hathwa Bishanpur Road,
Distt. Gopalganj, Bihar – 841436 Distt. Surguja, Chattishgarh – 497001
11. Principal 23. Principal
Sainik School Nalanda Sainik School Bhubaneshwar
PO-Rajgir, Distt. Nalanda, Bihar - 803116 Distt. Bhubaneshwar, Orissa -751005
12. Principal 24. Principal
Sainik School Goalpara Sainik School Ghorakhal
PO : Rajapara PO : Ghorakhal
Distt. Goalpara, Assam - 783133 Distt. Nainital, Uttarakhand – 263156

******
 -6-

LkSfud Ldwy ?kksM+k[kky] uSuhrky] mRrjk[k.M+ & 263156

fn’kk & funsZ’k
d`i;k vkosnu i= Hkjus ls iwoZ fuEufyf[kr fn’kk funsZ’kksa dks /;ku iwoZd i<sa A

1- ,d [kkuk izFke uke

uke ds ckn] f}rh; uke ds ckn rFkk vfUre uke ds ckn NksMsa A

2- tUe frfFk %& o"kZ 2011&12 gsrq 02 tuojh 2011 dks vk;ksftr ^vf[ky Hkkjrh; lSfud Ldwy izos’k ijh{kk ¥ esa
lfEefyr gksus@Hkkx ysus gsrq v/kksfyf[kr frfFk;ksa ds e/; tUes Nk=kss ls fn, x, izk:i esa vkosnu i= vkeaf=r gSa A

6oha ¼NBoha½ d{kk gsrq & 02 tqykbZ 2000 ls 01 tqykbZ 2001 rd ¼nksuksa fnol x.kuh;½
9oha ¼ukSoha½ d{kk gsrq & 02 tqykbZ 1997 ls 01 tqykbZ 1998 rd ¼nksuksa fnol x.kuh;½

3- iathdj.k ’kqYd %& iathdj.k ’kqYd vkosnu i= ds lkFk v/kksfyf[kr /kujkf’k ds fMekaM Mªk¶V ¼vgLrkUrj.kkh;½@okilh
Hkqxrku u gksus ;ksX;½ layXu djuk vko’;d gS A

¼d½ lkekU;@j{kk laoxZ % :0 500@&

¼[k½
[k½ vuqlwfpr tkfr@vuqlwfpr tutkfr % :0 350@&
fMekaM Mªk¶V ^iz/kkukpk;Z] lSfud Ldwy ?kksMk[kky ¥ ds i{k esa@uke ls Hkkjrh; LVsV cSad Hkokyh ’kk[kk ¼dksM+ u0 01352½ ij ns; gksuk
pkfg;s A vH;kFkhZ dk uke rFkk mlds firk dk uke cSad Mªk¶V ds ihNs fy[kk gksuk pkfg;s A psd] iksLVy vkMZ+j ¼Indian Postal
Orders½ fo|ky; dks Lohdh;Z ugha gksxsa A iathdj.k ’kqYd /kujkf’k fdlh Hkh fLFkfr fLFkfr esa okil ugha ykSVkbZ tk;sxh@Hkqxrku ugha dh
tk;sxh A

4- lSfud Ldwy ?kksM+k[kky] j{kk eU=ky; ¼Hkkjr ljdkj½ }kjk fu;af=r ,d Lok;r’kk"kh ifj"kn lSfud Ldwy lkslkbVh }kjk
lapkfyr ns’k ds 24 lSfud Ldwyksa esa ls ,d gS A jk"Vªh; j{kk vdkneh [kM+doklyk] iq.ks ds ek/;e ls j{kk lsukvksa@lsokvksa esa
izos’k gsrq Nk=ksa dks rS;kj djkus ,oa ifCyd Ldwy Lrj dh f’k{kk tu lkekU; Nk= rd igqWapkus@miyC/k djkus ds mn~ns’; ls bl Ldwy
dh laLFkkiuk dh x;h Fkh A

5- fjfDr;kWa %& NBoha d{kk esa & 60 lhVsa vuqekfur

ukSoha d{kk esa & 30 lhVsa
6- vkj{k.k %& fjDr lhVksa esa 67% mRrjk[k.M+ jkT; ds LFkk;kh fuokfl;ksa ds fy, rFkk ’ks"k 33% nwljs lHkh jkT;ksa@la?k
’kkflr izns’kksa ds fuokfl;ksa ds fy, fu/kkZfjr gSa A dqy fjDr lhVksa esa 15% lhVsa vuqlwfpr tkfr ds fy,] 7-5% lhVsa vuqlwfpr
tutkfr ds fy, ,oa izR;sd laoxZ esa ’ks"k lhVksa dk 25% lhV j{kk lSfudksa@j{kk dkfeZdksa ,oa HkwriwoZ j{kk lSfudksa@j{kk dkfeZdkasa gsrq
vkjf{kr gSa A

7- ijh{kk dsUnz %& i;kZIr vH;fFkZ;ksa@ijh{kkfFkZ;ksa dh miyC/krk ds vk/kkj ij vYeksM+k] cjsyh] nsnsgjknwu] ?kksM+k[kky] xksj[kiqj]
dksV}kj] y[kuÅ] fiFkkSjkx<+] :M+dh] Jhuxj ¼x<+oky½] ,oa m/ke flag uxj esa fyf[kr ijh{kk dsUnz gksxsa A ijh{kk dsUnzksa ds vkoaVu
dk LokRokf/kdkj iw.kZr;k fo|ky; ds ikl lqjf{kr gS A

8- fyf[kr ijh{kk dh vk;kstuk %& 6oha ¼NBoha½ d{kk esa izos’k gsrq fyf[kr ijh{kk izeq[kr;% nks iz’u i=ksa & xf.kr] Hkk"kk ,oa cqf}
dkS’ky dh ijh{kk] tks d{kk 5 ¼ikWpohaa d{kk½ ds Kku ij vk/kkfjr gksxh rFkk 9oha ¼ukSohaa½ d{kk esa izos’k gsrq fyf[kr ijh{kk izeq[kr;% nks
iz’u i=ksa & xf.kr] foKku ,oa lkekftd v/;;u@Kku dh ijh{kk] tks d{kk 8 ¼vkBohaa d{kk½ ds Kku ij vk/kkfjr gksxhA izos’k
ijh{kk dk ek/;e 6oha ¼NBoha½ d{kk gsrq fgUnh vFkok vaxzsth ysfdu 9oha ¼ukSoha½ d{kk gsrq dsoy vaxzsth ek/;e gh gksxk A

9- ’kqYd o"kZ 2011&12 ds fy, %& vkoklh;] f’k{kk ,oa vU; O;; ¼vuqekfur@yxHkx½ :0 90]000@& gksxk A orZeku fu;eksa
esa izfro"kZ 10% o‘f} ykxw gksxh A
 &7&

10- Nk=o‘fRr %& mRrjk[k.M jkT;+ ljdkj }kjk mRrjk[k.M+ jkT; ds LFkk;h fuoklh Nk+=ksa ds vfHkHkkodksa dh vk; ,oa Nk=ksa dh
;ksX;rk ds vk/kkj ij Nk=o‘fRr iznku dh tkrh gS A os Nk= tks j{kk lSfudksa@j{kk dkfeZdksa vFkok HkwriwoZ j{kk lSfudksa@HkwriwoZ j{kk
dkfeZdksa ds iq= o mRrjk[k.M+ jkT; ds fuokfl;ksa ds fy, 25% dksVs ds vUrxZr izfo"V gq, gSa] os j{kk ea=ky; }kjk lhfer la[;k esa
iznRr Nk=o‘fRr ds fy, ik= gSa A mRrjk[k.M++ ds LFkk;h fuoklh j{kk laoxZ lfgr Nk+=ksa ds fy, Hkkstu O;;@’kqYd esa NwV iznku dh
tkrh gS A blds vfrfjDr lSfud Ldwy ?kksM+k[kky ds (Day Scholars) vukokfld Nk=ksa dks NksM+dj lHkh Nk=ksa dks j{kk ea=ky;
}kjk dqN foRrh; lgk;rk iznku dh tkrh gS A ,d ckj iznRr Nk=o‘fRr dh fujUrjrk vfHkHkkod dh vk;] Nk= dk vuq’kklu Lrj
,oa ’kSf{kd izLrqfr@okf"kZd ijh{kk izkIrkad Lrj ij vk/kkfjr gS A

11- iquZijh{kk oftZr %& lSfud Ldwy uxjksVk ¼tEew d’ehj½ ds vfrfjDr] lSfud Ldwy esa fdlh ,d fof’k"V d{kk esa izos’k gsrq
vk;ksftr izos’k ijh{kk esa ,d Nk=+ ,d ckj gh lfEefyr gks ldrk gS A lHkh izdkj ds fookn fo/kk;h U;k;f/kdj.k uSuhrky ds
vUrxZr gksxsa A

12- vkosnu i=ksa dks tek djus dh vfUre frfFk %& iw.kZr;k Hkjs gq, vkosnu i= ¼ijh{kk Hkou izos’k i=] ifjp; izek.k i=
,oa iathdj.k ’kqYd dk fMekUM Mªk¶V lfgr½ 10 fnlEcj 2010 rd ;k blls iwoZ ^iz/kkukpk;Z] lSfud Ldwy ?kksM+k[kky] iksLV
?kksM+k[kky] ftyk uSuhrky] mRrjk[k.M++ 263156 ds ikl igqWp tkus pkfg;s A viw.kZ vkosnu i= fujLr gks tk;sxsa@dj fn, tk;saxsa A
Mkd dh nsjh otg ls izkIr vkosnu i= Hkh fujLr dj fn;s tk;saxsa rFkk bl laca/k esa dksbZ Hkh i= O;ogkj@tu laokn Lohdk;Z ugha
gksxk A ,d ckj iznRr@tek iathdj.k ’kqYd /kujkf’k fdlh Hkh ifjfLFkfr esa ykSVkbZ ugha tk;sxh A M+kd dh nsjh ds fy, Ldwy
ftEesokj ughaa gksxk A dksfj;j lsok lSfud Ldwy ?kksM+k[kky ds fy, miyC/k ugha gS A

13- vkosnu izi= Ldwy csclkbV www.ssghorakhal.org ij Hkh miyC/k gSa A

14- vfHkHkkodksa ls vuqjks/k gS fd QkeZ dsoy Nk=ksa ds fy;s gh Hkjsa] Nk=kvksa ds fy;s ugha A dksfj;j lsok uSuhrky@gY}kuh ls
lSfud Ldwy ?kksM+k[kky ds fy, miyC/k ugha gS A leLr i=kpkj Hkkjrh; M+kd }kjk gh Hkstsa A dksfj;j ls Hksth xbZ Mkd ds fy, Ldwy
ftEesokj ugha gksxk A

iz/kkukpk;Z
lSfud Ldwy ?kksM+k[kky]
iksLV ?kksM+k[kky
ftyk uSuhrky] mRrjk[k.M+ & 263156
nwjHkk"k & 05942&220051] 220045
csclkbV : www.ssghorakhal.org
tkudkjh dk le; % lqcg 0900 cts ls 1200 cts rd]rFkk
nksigj 1500 cts ls ’kke 1700 cts rd ¼’kfuokj dks NksM+dj½

*******