Brahm Dutt Blue Bells Public School

Sector-10, Urban Estate, Gurgaon-122001

(Affiliated to C.B.S.E.)
(vide CBSE affiliation no. 530482)
E-mail Id- bbpublic@bluebells.org
Website: www.bluebells.org/bbpublic
Sponsored By:
Sh. D.R. Memorial Bal Shiksha Vikas Society (Regd.)

Registration Form for Class XI / XII

 
 

Instruction: 1. Size of Images to be uploaded should be more than 500 KB and less than 2 MB.
2. School will communicate on the email provided by you for Communication.

 
Enquiry No.
Mobile No.
 
Applying for Class*
 
Student Photo*
Father Photo*
Mother Photo*
 
 
Student First Name*
Student Middle Name
 
Student Last Name
Gender*
 
Date of Birth*
Date of Birth (In Words)*
 
Birth Certificate of Child
Current Address Proof*
 
Nationality
Student Aadhar No.
 
Mobile*
Email for Communication *
Present Address
Sector/Locality/Apartments* City* State* Pin* Country* Tel No. (Landline)*
Permanent Address
Sector/Locality/Apartments* City* State* Pin* Country*
Father Name*
Mother Name*
 
Father Mobile No.*
Mother Mobile No.*
 
Father Aadhar No*
Mother Aadhar No*
 
Father Qualification
Mother Qualification
 
Father Occupation
Mother Occupation
 
Father Designation
Mother Designation
 
Father Office Address
Mother Office Address
 
Father Office Tel No.
Mother Office Tel No.
 
Email Id (Father)*
Email Id (Mother)
 
Name of the School last attended*
Affiliated to Board*
 
Class X Marks Obtained*
Percentage (%) of marks*
 
Identity Proof of Parents :*
Board Marksheet / Mid term1 board Marksheet of Class X :
 
CBSE Registration details from last School :
 

Please select preference of stream and optional subjects from list below

Stream Preference* Subjects Available* Optional Subject 1* Optional Subject 2*

Please enter marks obtained in Class X

Subject English* Science* Maths* Social Science*
Marks Obtained
Total of ESM
(English, Science & Maths)
Percentage (%) of ESM
 
Total of ESM
(English, S. St. & Maths)
Percentage (%) of ESM
 
Sports Events at District Level
Sports Events at State Level
 
Sports Events at National Level
Literary Events
 
Cultural Events
Fine Arts
 
Any Other Events
Enter Remarks(If Any)
 

☞ Attached photocopies of Marks Statement and certificate copies of co-curricular activities (If Any)

Marks Statement
(jpg,png,pdf)
 
 
Co-Curricular Certificate Co-Curricular Certificate Co-Curricular Certificate Co-Curricular Certificate

☞ Details of Siblings in Blue Bells Model School (If Any)

Sibling Admission No. Mobile No. Student Name Class
First Sibling
Second Sibling

☞ Alumni Details (If Any)

Alumni Name
Relation with the child
 
Passing out Class
Passing out Year
 
From Year
To Year
 
 
I hereby declare that the information furnished above is complete and correct to the best of my knowledge.