	SENSEI SANTU DAS
	President of (S.S.S.S.M.A.) President of East Medinipur (S.S.S.S.M.A.) 3rd Dan Black Belt (AISSKF), 2nd Dan Black Belt (NATIONAL) National Judge (A Grade), National Coach, Examiner

ADMISSION FORM

APPLICATION FORM FOR ADMISSION

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*1. Name of the Applicant Mr. / Ms. :**
*2. Father’s Name / Gradian's Name :**
3. Gender :	Male Female
4. Category :	GEN SC ST OBC
*5. Date of Birth :**
*6. Course Appling For :**
*7. Enter School Name :**
8. Nationality :	Indian
9. Religion :	Hindu Islam Sikh Other
*10. Address :**
*11. Admission Date :**
*12. Branch Name :**
*13. Admission Fees :**
*14. Pay Type :**
Declaration - I do hereby confirm that all the information given above is correct and promise to abide by all the rules and regulations of the S.S.S.S.M.A.