DELHI PUBLIC SCHOOL UJJAIN

Jaiwantpur Maksi Road, Ujjain
Email: info@dpsujjain.org
Tel: 081032 58777

Registration Form

Student

Father

Mother

     
Registration No.: etpl:registrationno

Sibling Details
Sibling (Real Brother/ Sister) only studying in Abhinav Global School : etpl:is_sibling Admission No. : etpl:sibling_adm_no
Sibling Name : etpl:sibling_name Sibling Class : etpl:sibling_class

Student Details
Student First Name : etpl:firstname Middle Name : etpl:middlename
Last Name : etpl:lastname Gender : etpl:gender
Date of Birth : etpl:dateofbirth Category : etpl:category
Nationality : etpl:nationality Class : etpl:classname
Adhaar No. : etpl:aadhar_no Email : etpl:emailid
Religion : etpl:religion  Any Know Allergies or Medical Conditions  : etpl:__ufdkey__any_allergy

Communication Address
Address : etpl:add_correspondence Country : etpl:co_correspondence
City : etpl:ct_correspondence State : etpl:st_correspondence
Pin Code : etpl:pn_correspondence    

Permanent Address
Address : etpl:address City : etpl:city
State : etpl:state Pin Code : etpl:pin

Permanent Details

Father
Name : etpl:fathername Mobile no. : etpl:fathermobileno
Educational Qualification : etpl:father_qualification Occupation : etpl:father_occupation
Designation : etpl:fatherdesignation Organisation : etpl:father_organization
Office Address : etpl:fatherofficeaddress E-mail : etpl:father_email
       

Mother
Name : etpl:mothername Mobile no. : etpl:mothermobileno
Educational Qualification : etpl:mother_qualification Occupation : etpl:mother_occupation
Designation : etpl:motherdesignation Organisation : etpl:mother_organization
Office Address : etpl:motherofficeaddress E-mail : etpl:mother_email

Declaration
1. I know the registration fee is non-refundable and I fully understand that registration does not guarantee admission.
2. I hereby certify that the date of birth and spelling of the name of my child given in this form are correct and I shall not make any request for any change there in.
3. I understand that rendering false / misleading information and documents may disqualify my ward for admission /education in this school.
4. I hereby undertake that my ward and myself shall follow the rules, regulations and procedures laid down by the school from time to time.
5. I am hereby signing to cofirm the above declaration.
Please bring the original documents to be verified at the time of submission of the photocopies.
     

Date

 Signature of Mother

Signature of Father