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.
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. 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.