Registration Form

DELHI PUBLIC SCHOOL RANIPUR, HARIDWAR
SEC. III, BHEL, RANIPUR, HARIDWAR (UTTARAKHAND)
CBSE AFFILIATION NO. 3530008
REGISTRATION FORM 2021 - 2022
FOR PREP JUNIOR
NOTE: FILL THE FORM IN CAPITAL LETTERS
NOTE: ALL �*' MARKED FIELDS ARE MANDATORY. PLEASE MENTION 'NA� IF NOT APPLICABLE.

Proceed for payment, if Registration Form already filled

Student Details

* First Name

Middle Name

Surname

* Candidate Photo

* Please Note that child's name should be the same as in the Date of Birth Certificate. No change afterwards.

* Date of Birth (dd-MM-yyyy)

Place of Birth

Submission of Date of Birth Certificate issued only by Registrar Birth & Death of Municipal Corporation / Municipality at the time of admission is a must.

* Blood Group

* Gender

* Nationality

* Caste Category

* Submission of certificate at the time of admission is a must.

Aadhar Number, (if any)

* Hometown

* Religion

* Minority

* Specially abled (Divyangjan)

Mother Tongue

If child has any medical problems (like diabetes etc), give details and submit the medical certificate for the same.

If child is allergic to any substance (like nuts etc.), give details and submit the medical certificate for the same.

* Category

* Tuition Fee Category

* Transport Category

* Birth Certificate

If by bus, choose Student picking point :

Parent(s) is/are BHEL Employee (Yes/No)

* If parent(s) is/are Ex-student of
DPS Ranipur

* If your ward is Girl Child (Yes/No)

* Choose category, If you are a Single parent

If real brother / sister is studying in
DPS Ranipur

Communication Details

* Email:

* Mobile No. for SMS:

PARENTAL INFORMATION
Father's Details

* First Name		Middle Name
Surname		Staff No. (in case father is BHEL employee)
* Academic Qualifications		* Occupation
Father Other Occupation
Designation		Organization
* Gross Annual Income		* Address (Off.)
* Mobile		* E-mail
* Residential Address		Permanent Address
Home Town		* Pincode
Phone No (O)		(R)
Father Aadhar No.


Mother's Details

* First Name		Middle Name
Surname		Staff No.(in case mother is BHEL employee)
* Educational qualification		* Occupation
Mother Other Occupation
Designation		Organisation
Annual Income		* Address(Off.)
* E-mail		* Mobile
* Residential Address		Permanent Address
Home Town		Pincode
Phone No (O)		(R)
Are the parents not residing in Haridwar with the child		Mother Aadhar No.

Guardian Details

* In case the parents are not residing in Haridwar with the child


First Name		Middle Name
Surname		Relationship with the Child :
Occupation		Designation
Other Guardian Occupation:
Residential Address		Permanent Address
Pincode		Gross Annual Income
Phone No (O)		(R)
Mobile No		Email

Criteria & Point-wise weightage
* BHEL Employee Ward / Regular DPS Staff Ward:
* Neighborhood:
* Sibling:
* Ward of Alumni / Ex-student of DPS Ranipur:
* Girl Child / Single Parent:

I certify that the particulars given by me above are correct.

(Father)

(Mother)

(Gauardian)

Neighborhood : Criteria Point

Sr. No.	Location	Marks
(a)	Whole BHEL Campus	40
(b)	PAC, Shivalik Nagar, Subhash Nagar, Tehri Visthapit Colony (Adjacent to Payal cinema)	36
(c)	Dheerwali, Neel Khudana, Kadach Mohalla	32
(d)	Jagdish Nagar, Ambedkar Nagar, Sanjay Colony, Rawali Mehdood, Shyam Nagar, SIDCUL (Indralok, NRI City Antriksh), Vivek Vihar, Sharda Nagar, Shivlok, Nandpuri, Model Colony, Panchwati Colony, Prem Nagar, Govindpuri, Arya Nagar, Ranipur More, Khanna Nagar, Yogi Vihar	24
(e)	Rishikul, Gyanlok Colony, Ramnagar, Miyana Mohalla, Mayapur, Vishwa Kalyan, Shiv Nagar-2, Kankhal, Brahm Vihar Colony, Salempur Mehdood, Nirmala Chawoni, Sarva Priya Vihar Colony, Deep Ganga (SIDCUL), Ind. Area Bahadrabad (Indian Oil Bottling Plant), Jurs Country	16
(f)	Haridwar Greens, Gurukul Kangri University, Brahmpuri, Birlaghat, Roshnabad, Har Ki Pauri	8
(g)	Other places - beyond 10 kms radius	0