	Delhi Public School Bharuch
	Bharuch Campus, Paguthan-aldar Road, Opp. CLP India, Aldar, Bharuch - 392 015 Tel: 7567133626, 9099598295, 9099598245 \| Email: info@dpsbharuch.com
	Application Form

Application No.: etpl:app_form_no


Father	Student	Mother

Sibling Details

Sibling (Real Brother/ Sister) only studying in DPS Bharuch :

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

Student Middle Name :

etpl:middle_name

Student Last Name :

etpl:lastname

Gender :

etpl:gender

Date of Birth :

etpl:dateofbirth

Admission sought in Class:

etpl:classname

Current Class :

etpl:currentclassname

Current School:

etpl:currentschoolname

Category :

etpl:category

Staff Name:

etpl:__ufdkey__schoolstaffname

Religion :

etpl:religionid

Aadhar No.:

etpl:aadhar_no

Email :

etpl:emailid

Mobile No.:

etpl:mobileno

Mother Tongue :

etpl:mother_tongue

First Language Prefered:

etpl:__ufdkey__firstlangpref

Optional Language Preferred (VI-VIII) :

etpl:__ufdkey__optionallangVItoVIII

Optional Language Preferred (IX-X) :

etpl:__ufdkey__optionallangIXtoX

Do You Need Transport :

etpl:is_transport

Bus Stop:

etpl:bus_stop

If Transport Facility not Available, would You Still Seek Admission? :

etpl:__ufdkey__transportnotavailabale

Special Skills and Interests of Student :

etpl:__ufdkey__specialskills

Communication Address

Address :

etpl:add_correspondence

Country :

etpl:co_correspondence

City :

etpl:ct_correspondence

State :

etpl:st_correspondence

Pin Code :

etpl:pn_correspondence

Residential Address

Address :

etpl:address

City :

etpl:city

State :

etpl:state

Pin Code :

etpl:pin

Father's Details

Father Name :

etpl:fathername

Qualification :

etpl:father_qualificationid

Occupation :

etpl:fatherprofession

Designation :

etpl:fatherdesignation

Organisation :

etpl:father_organization

Annual Income :

etpl:fatherannualincome

Phone(Off.) :

etpl:father_office_no

Address(Off.) :

etpl:fatherofficeaddress

E-mail :

etpl:father_emailid

Mobile No. :

etpl:fathermobileno

Mother's Details

Mother Name :

etpl:mothername

Educational Qualification :

etpl:mother_qualificationid

Occupation :

etpl:motherprofession

Designation :

etpl:motherdesignation

Organisation :

etpl:mother_organization

Annual Income :

etpl:motherannualincome

Phone(Off.) :

etpl:mother_office_no

Address(Off.) :

etpl:motherofficeaddress

E-mail :

etpl:mother_emailid

Mobile No. :

etpl:mothermobileno

No. of Sons :

etpl:__ufdkey__noofsons

No. of Daughters :

etpl:__ufdkey__noofdaughters

Note:- You can go to school with application form. You can pay with Debit/Credit Card or DD only /-

Date :

Parent's Signature :