STUDENT REGISTRATION FORM (2018-19)

Sibling Detail (only real brother / sister currently studying in this school)

Sibling :

Admission No. :

Sibling Name :

Sibling Class :

Application Form Information

Class Applied for :

Admission No. :

Personal Information

Prefix :

First Name :

Middle Name :

Last Name :

Date of Birth (dd-mm-yyyy):

DOB Certificate No. :

Age as on

Date

Place of Birth :

Mother Tongue :

Email (for communication) :

Aadhar No ::

Nationality :

Mobile No.
(for communication) :

Landline No. :

Gender :

Only Child :

Address :

City :

State :

Country :

PIN :

State of Domicile :

Category :

Religion :

Bank Account no

IFSC code

Any medical condition
requiring School's special
attention :

Remarks :

Distance From School(In K.M.)

School Transport Required :

Bus Stop :

Other Stop :

Father's Detail

Prefix :

First Name :

Middle Name :

Last Name :

Email Id :

Mobile Number :

Landline Number :

Occupation :

Organization :

Office Address :

Qualification :

Designation :

Annual Income (In Rupees):

Mother's Detail

Prefix :

First Name :

Middle Name :

Last Name :

Email Id :

Mobile Number :

Landline Number :

Occupation :

Organization :

Office Address :

Qualification :

Designation :

Annual Income (In Rupees):

No. of Son(s) :

No. of Daughter(s) :

Additional Information

Previous Class :

Previous School Name :

Board Name :

Source of Information :

Last examination result in % age of Marks :

Status of previous Year :

Following documents are required to submit along with the form:

1.Birth certificate issued by Competent Municipal Department

2.Document for Address proof (Any one of following):

(i) Voter ICard

(ii) Aadhar Card

(iii) Electricity bill/ MTNL bill/Water bill

(iv) Passport in the name of the parents or the child

(v) Rent Agreement

3. In case of SC/ST/OBC/Other applicants, Caste certificate issued by Deputy Commissioner Office need to be submitted.

4. In case of child with special needs/disabilities, medical certificate from the Govt. Hospital needs to be submitted.

5. Hard copy (Print Out) of this form is required to be submitted at the school reception within a week. Timing for submission of the form will be 08:00am to 12:00 noon.

6. Registration fee of Rs. 25/ is to be deposited at the school reception along with the form.

7. T.C countersigned by Edu. Officer

Note:- Please Attach a copy of the academic progress Report obtained from the previous school.

I............................................................................................ Parent/Guardian of ......................................................................................................... (admission no.).................................................................................... Understand that this is only a provisional stream alloted which will be finalized after the declaration of class X result.

I,..................................................................................,PARENT/GUARDIAN OF .............................................................., DO HEREBY DECLARE THAT INFORMATION GIVEN ABOVE IS BASED ON FACTS AND AUTHENTIC RECORDS, AND I FULLY UNDERSTAND THAT REGISTRATION /ADMISSION OF MY WARD WILL NOT BE CONSIDERED /WILL BE CANCELLED IF ANY OF THE ABOVE MENTIONED INFORMATION IS FOUND TO BE INCORRECT.

SIGNATURE OF FATHER/MOTHER/GUARDIAN