UGYEN Academy

Khuruthang, Punakha: Bhutan

Application form for admission to class VII Only

Bio-data (To be filled by the applicant)

 Name:                                   Gender:                                                      

 Date of Birth:       Date                               Month                     Year          

Village:                  Geog:      
Dzongkhag:     House No:    
Tharm No:    I.D Card No:   
Father's Name:      Occupation:    
Mother's Name:    Occupation:   

Contact Address (Present mailing address of the parent/guardian financing the applicant's education-please provide phone/mobile number)

  

Phone/Mobile number of the nearest guardians/parents in case of emergency:       

Email Address :             

Accommodation

Day Scholar                                   Boarder

Schooling History

Name of the school (from where the applicant appeared class SIX examination)                

Subject English Dzongkha Maths HCG PCB CTS/ECO Average(%) SUPW
Marks

       

                                                                              

 Other school attended:

Name of other school attended:

 Class
Year
From To From To
  

  

  

  

  

  Personal Characteristics

My three good/strong points are: My three weak points/weaknesses are:
1    1          
2 2
3 3

IMPORTANT