JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Consent Form - SIRS
We are pleased to inform you that we shall be welcoming our students of Class XI to school from Thursday, October 21, 2021.
You are hereby requested to submit the Online Consent Form latest by Monday, 11 October, 2021.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name of Parent/ Guardian
*
Your answer
Mobile Number
*
Your answer
Email ID
*
Your answer
Whether Resident of Odisha
*
Yes
No
Name of Student
*
Your answer
Admission Number
*
Your answer
House
*
Your answer
Gender
*
Female
Male
Residential Address
*
Your answer
Select Class of Student
*
X
Are you willing to send your ward to school on voluntary basis, for taking guidance from their teachers?
*
Yes
No
Do you agree to get the RT-PCR test conducted on your ward 72 hours before joining the school and will deposit a copy of the report with the Resident Medical Officer (RMO) on arrival?
*
Yes
No
Will you ensure that you and your ward follow all the safety protocols as prescribed by the State Government, the same have duly been put in place by the school?
*
Yes
No
Will you avoid frequently visiting your ward while he/ she is back in school?
*
Yes
No
Will you educate your ward to use technology constructively and not misuse the laptop / ipad / cell phones / internet that is being allowed strictly for attending Online Classes as a part of the Blended Learning Programme of the school?
*
Yes
No
Will you extend your fullest cooperation to the school management in bringing out the best in your child and assist the school in which ever manner possible in case required?
*
Yes
No
Do you agree that we are living in unprecedented times and that you need to hold one hand of your child while the teachers shall hold the other?
*
Yes
No
Name of Parent/ Guardian
*
Your answer
Mobile Number
*
Your answer
Email ID
*
Your answer
Whether Resident of Odisha
*
Yes
No
Name of Student
*
Your answer
Admission Number
*
Your answer
House
*
Your answer
Gender
*
Female
Male
Residential Address
*
Your answer
Select Class of Student
*
X
Are you willing to send your ward to school on voluntary basis, for taking guidance from their teachers?
*
Yes
No
Do you agree to get the RT-PCR test conducted on your ward 72 hours before joining the school and will deposit a copy of the report with the Resident Medical Officer (RMO) on arrival?
*
Yes
No
Will you ensure that you and your ward follow all the safety protocols as prescribed by the State Government, the same have duly been put in place by the school?
*
Yes
No
Will you avoid frequently visiting your ward while he/ she is back in school?
*
Yes
No
Will you educate your ward to use technology constructively and not misuse the laptop / ipad / cell phones / internet that is being allowed strictly for attending Online Classes as a part of the Blended Learning Programme of the school?
*
Yes
No
Will you extend your fullest cooperation to the school management in bringing out the best in your child and assist the school in which ever manner possible in case required?
*
Yes
No
Do you agree that we are living in unprecedented times and that you need to hold one hand of your child while the teachers shall hold the other?
*
Yes
No
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of SAI International Residential School.
Report Abuse
Forms
