HSEC Student Application Form

Student Application Form

We thank you for starting your journey with us. All fields in this form are compulsory. If some are not applicable, please do type in as Not Applicable.
Instructions for filling in the Application Form

All Fields are compulsory. If it is not applicable, please fill as "Not Applicable"

Step 1: Fill in the details
- Enter all relevant details carefully. Data Once Submitted can not be changed. So Please take a look before final Submission.
- Keep Ready a scanned color copy of Student's Photo in jpg/jpeg format
- Take a Printout of the Application form before pressing the Submit Button. You can sign the hard copy of the application form and submit it along with copies of the documents.
- All copies of documents should be self-attested.
- The original documents should be brought to the school for verification and return
- The original transfer certificate from the current school (where applicable) will be retained by the School.
Step 2: Confirmation of Submission
- Press the Submit Button
- After Successfull Submission of Application Form, you will get a confirmation message on screen
- Attach all the relavent documents with Printed Application Form, Sign the Form and submit the documents in the Admissions Office when you are called by the School for a Student Assessment and Interview of Parents.

Student Information
Field of Study Interest*
eg. 2018-19
Country of Study Interest*
Std.1, Std. 2, etc
Student's Name*

First NameMiddle NameLast Name
Date of Birth *

DayMonthYear
Student Passport Photograph*
Gender*
Nationality*
Current Address *

Street Address

Street Address Line 2

CityState / Province

Zip CodeCountry
Religion*
For Govt Reporting Only

Present School Information
Name of School*
School Contact Name*
Phone Number*
Official School Email*
Present Grade/Level*
Type of Secondary School Attended*
Second Language*
Date Attended From

DayMonthYear
Date
Date Attended To

DayMonthYear
Date

Student Information (Medical History)
Blood Group
Food Allergies if any
Family Doctor Name
Medicine Allergies, if any
Family Doctor's Mobile No.
Current Ailments or Diseases being treated for
Communicable Diseases the child had in the past

Chicken PoxHepatitisMumpsWhooping CoughOther
If the child has been hospitalized, dates with reasons
Can the student take part in physical activities, sports, atheletics?

Student Information (Other)

Sibling Details

Rows	Name	Standard	School
Sibling 1
Sibling 2
Sibling 3
Sibling 4

Has the student been double promoted or detained in a standard? If yes, provide details
Has the student been expelled from any School? If yes, provide details
Please mention special talents that the student has?

Parent Information
Marital Status*
School Communication should go to*
Father's Name*
Mother's Name*
Father's Occupation*
Mother's Occupation*
Father's Education Level*
Mother's Education Level*
Father's Office Number
Mother's Office Number
Father's Mobile Number*
Mother's Mobile Number*
Father's Email ID*
Mother's Email ID*
Father's Address*

Street Address

Street Address Line 2

CityState / Province

Zip Code
Mother's Address (If different from Father's Address)

Street Address

Street Address Line 2

CityState / Province

Zip Code

Guardian and Emergency Contact Information
Is there a guardian?
If yes, name of guardian
Relationship with Student
Telephone number
Email ID
Address

Street Address

Street Address Line 2

CityState / Province

Zip Code
Emergency Contact Name
Emergency Contact Tel No.
Emergency Contact Email ID
Relationship with Student
Address

Street Address

Street Address Line 2

CityState / Province

Zip Code

Documents to be Uploaded
Address Proof

Cancelof
Present School's Statement of Results (Official Transcript)

Cancelof
Student's Health Record

Cancelof
Written Performance Report from Present School

Cancelof

What is your career goal?
What are your strengths, interests and skills?
Why do you want to study abroad?

Acceptance of Terms & Conditions and Declaration of Parents/Guardian
Declaration by Parents/Guardian

We are seeking admission for our daughter/son (hereinafter referred to as Child) to study abroad through the help of Havilah Student Edu-Universe Consult (hereinafter referred to as HSEC) after having read, understood and agreed with the terms and conditions below. We accept them and confirm that our acceptance has not been obtained by any kind of pressure or coercion of any nature whatsoever by the Management of HSEC.
1. This application has been made by us after having read and understood all the rules of HSEC.
2. We declare that the information furnished by us in this application is true to the best of our knowledge and belief.
3. We fully understand that the admission to study abroad is based on merit and on availability of a seat at the time of scrutiny of our application and when we are called for the offer of a seat.
4. We understand the the admission being given to the child is provisional and the same may be cancelled should any of the statements made in this form is false or the relevant documents are not produced within the 2 months of filing this application unless a different timeline has been agreed up on with HSEC in writing.
5. We fully understand and accept that the fee is required to be paid on or before our child is enrolled in HSEC's admission prep program. We also understand and accept that fees once paid, shall not be refunded under any circumstances by HSEC.
6. In the event of a fee payment cheque being dishonoured, the Management of HSEC reserves the right to dismiss/de-enroll the child at its discretion and levy any other penalty as it may deem fit.
7. HSEC reserves the right to increase/ revise/amend the fee structure and/or the fee to be charged from time to time. These changes could be in line with changes in Government Policies and/or the economic situation (including, but not limited to, inflation, etc.).
8. We understand and accept that HSEC has the right to use our child's photograph for any publicity material, website, social media page/s, unless the same has been expressly objected to by us and intimated in writing to the School by us before the commencement of the Academic Year.
9. We agree that our child will strictly follow the timeline set by HSEC for efficiency.
10. We understand and accept that our child may be removed from HSEC's program for non payment of dues, for any infringement of rules of conduct.
11. By pressing the Submit Button, we confirm the above declaration and accept the terms and conditions.
Signature

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Student Application Form

Student Information

Present School Information

Student Information (Medical History)

Student Information (Other)

Parent Information

Guardian and Emergency Contact Information

Documents to be Uploaded

Acceptance of Terms & Conditions and Declaration of Parents/Guardian