DELHI PUBLIC SCHOOL RANIPUR, HARIDWAR
CBSE AFFILIATION NO. 3530008
SEC. III, BHEL, RANIPUR, HARIDWAR (UTTARAKHAND)
REGISTRATION FORM FOR PREP JUNIOR SESSION/NURSERY 2022 - 2023

Registration Number etpl:registrationno

Date :

 etpl:registrationdate
DETAILS OF THE CHILD
Name of the child etpl:firstname etpl:middlename etpl:lastname
Please Note that child name should be same as in the Date of Birth Certificate. No changes afterward.
Gender etpl:gender
Date of Birth (In Figures) etpl:dob
(In Words) etpl:w_dob
Submission of Date of Birth Certificate issued only by Registrar Birth & Death of Municipal Corporation / Municipality at the time of admission is a must.
Age on 31st March, 2022 etpl:age_as_on
Nationality of the Child etpl:nationality
Religion etpl:religion
Mother Tongue etpl:mother_tongue
Home Town etpl:city
Blood Group

etpl:bloodgroup

Aadhar Card No (if any) etpl:aadhar_no
Minority

etpl:__ufdkey__Minority
Specially abled (Divyangjan)

etpl:__ufdkey__Speciallyabled
Caste Category

etpl:category
Category

etpl:__ufdkey__category1
Tuition Fee Category

etpl:studenttype
Transport category

etpl:__ufdkey__transcategory
If by bus, choose the Student picking point

etpl:__ufdkey__pickuppoint
If parent(s) is/are Ex-student of DPS Ranipur: etpl:__ufdkey__pxstudent
If your ward is Girl Child

etpl:__ufdkey__girlchild
Choose the category, If you are a Single parent etpl:__ufdkey__singleparent
If real brother / sister is studying in DPS Ranipur etpl:is_sibling
Admission No. of real brother/sister etpl:sibling_adm_no
Class & Section etpl:__ufdkey__classofbs
Name of Brother/Sister etpl:sibling_name
Admission No. of real brother/sister etpl:__ufdkey__Second_Sibling_Admission_No
Class & Section etpl:__ufdkey__Second_Sibling_Class
Name of Brother/Sister etpl:__ufdkey__Second_Sibling_Name
If child has any medical problems (like diabetes etc), give details and submit the medical certificate for the same etpl:__ufdkey__medical_problem
If child is allergic to any substance (like nuts etc.), give details and submit the medical certificate for the same etpl:__ufdkey__allergic
Mobile No. for SMS etpl:mobileno
Email etpl:emailid

PARENTAL INFORMATION
DETAILS OF THE FATHER
Father's Name etpl:father_name
Academic Qualifications etpl:father_qualification
Occupation etpl:father_occupation
Designation etpl:father_designation
Name of Office & full Address etpl:father_office_address
Staff No. (in case father is BHEL employee) etpl:__ufdkey__fatherstaffno
Gross Annual Income etpl:father_annual_income
Residential Address

etpl:address
Permanent Address etpl:__ufdkey__PA
Home Town etpl:__ufdkey__fht
Phone Number etpl:father_landline
Mobile Number (+91) etpl:father_mobileno
Email etpl:father_email
Father Aadhar No. etpl:__ufdkey__fatheraadharcardno
DETAILS OF THE MOTHER
Mother's Name etpl:mother_name
Academic Qualifications etpl:mother_qualification
Occupation etpl:mother_occupation
Designation etpl:mother_designation
Name of Office & full Address etpl:mother_office_address
Staff No. (in case mother is BHEL employee)

etpl:__ufdkey__motherstaffno
Gross Annual Income etpl:mother_annual_income
Residential Address

etpl:__ufdkey__mother_address
Permanent Address etpl:__ufdkey__mpa
Home Town etpl:__ufdkey__mht
Phone Number etpl:mother_landline
Mobile Number (+91) etpl:mother_mobileno
Email etpl:mother_email
Mother Aadhar No. etpl:__ufdkey__motheraadharcardno
Are the parents not residing in Haridwar with the child etpl:__ufdkey__prhc
DETAILS OF THE GUARDIAN
Guardian's Name etpl:__ufdkey__guardianlastname
Relationship with the child

etpl:__ufdkey__guardianrelation
Occupation

etpl:__ufdkey__guardianoccupation
Designation

etpl:__ufdkey__guardiandesignation

Name of Office & full Address etpl:__ufdkey__guardianofficeno
Gross Annual Income etpl:__ufdkey__guardian_gross_income
Residential Address

etpl:__ufdkey__guardianresadd
Permanent Address etpl:__ufdkey__gpaa
Phone Number etpl:__ufdkey__guardianresphone
Mobile Number (+91) etpl:__ufdkey__gmn
Email

etpl:__ufdkey__guardianemail
CRITERIA & POINT-WISE WEIGHTAGE
BHEL Employee / Regular DPS Staff Ward etpl:criteria_bhel_employee_ward_/_regular_dps_staff_ward
Neighbourhood: Residence etpl:criteria_neighborhood
Sibling (upto one child) etpl:criteria_sibling_upto_one_child
Ward of Alumni / Ex-student of DPS Ranipur etpl:criteria_ward_of_alumni_/_ex-student_of_dps_ranipur
Girl Child / Single Parent etpl:criteria_girl_child_/_single_parent
I hereby declare that the above information furnished by me is correct to the best of my knowledge and belief. I shall abide by the rules of the school.
(FATHER) (MOTHER) (GUARDIAN)

SCHOOL COPY - DETAILS OF THE DOCUMENTS SUBMITTED

Student Name: etpl:name Registration No: etpl:registrationno

CATEGORY

DPS Staff Child

BHEL

Non BHEL

S.NO

Documents to be collected

Remarks

1

Registration Form

YES

NO

2

School's copy of challan for processing charges

YES

NO

3

Photocopy of date of birth certificate

YES

NO

4

Caste category certificate

YES

NO

5

Alumni proof

YES

NO

6

Single parent proof

YES

NO

7

Sibling proof

YES

NO

8

Employer certificate (NON BHEL)

YES

NO

9

Income certificate

YES

NO

10

Address / residence proof ( affidavit if rental accommodation)

YES

NO

11

Affidavit by parents (mentioning that the above documents submitted are true and correct)

YES

NO

I certify that the particulars given by me above are correct. Date:: .............................................
FATHER MOTHER GUARDIAN
etpl:fathername etpl:mothername etpl:__ufdkey__guardianfirstname etpl:__ufdkey__guardianmiddlename etpl:__ufdkey__guardianlastname

--------------------------------------
Incharge Students Section (Name with Signature)

------------------------------------------------------------------------------------

PARENT COPY - DETAILS OF THE DOCUMENTS SUBMITTED
Student Name: etpl:name Registration No: etpl:registrationno

CATEGORY

DPS Staff Child

BHEL

Non BHEL

S.NO

Documents to be collected

 

 

Remarks

1

Registration Form

YES

NO

 

2

School's copy of challan for processing charges

YES

NO

 

3

Photocopy of date of birth certificate

YES

NO

 

4

Caste category certificate

YES

NO

 

5

Alumni proof

YES

NO

 

6

Single parent proof

YES

NO

 

7

Sibling proof

YES

NO

 

8

Employer certificate (NON BHEL)

YES

NO

 

9

Income certificate

YES

NO

10

Address / residence proof ( affidavit if rental accommodation)

YES

NO

 

11

Affidavit by parents (mentioning that the above documents submitted are true and correct)

YES

NO

 
Certified that I have checked the registration form and the relevant papers / documents are found in order.  
    Date:

.....................................................................................
Incharge Students Section (Name with Signature)
Delhi Public School Ranipur, Haridwar

    

DELHI PUBLIC SCHOOL RANIPUR, HARIDWAR
SEC. III, BHEL, RANIPUR, HARIDWAR (UTTARAKHAND)
CBSE AFFILIATION NO. 3530008

REGISTRATION FORM 2022 - 23
CLASS - PREP JUNIOR/NURSERY

Office Copy
Applicant's Details Receipt Details
Applicant's Name : etpl:firstname etpl:middlename etpl:lastname Registration No. : etpl:registrationno
Father's Name : etpl:father_first_name etpl:father_middle_name etpl:father_last_name Receipt No. : etpl:receipt_no
Mother's Name : etpl:mother_first_name etpl:mother_middle_name etpl:mother_last_name Receipt Date : etpl:registrationdate
Address : etpl:address Class Applied : etpl:classname
Phone No. : etpl:mobileno For the Session : 2022-23
Fee Particulars Payment Mode Amount
Processing Charge Online 1000.0
Amount in Words: Five Hundred Rupees Only