• Bhorugram, Nangal Bari, Rajgarjh, Churu, Rajasthan
  • 01559-234425,234402 brjd@rediffmail.com
  • Note: All '*' marked fields are mandatory. Please mention 'NA' if not applicable.

Proceed for Payment If Application form Already Filled.

Sibling Details

Sibling (Real Brother/ Sister) only studying in BRJD Pubic School - BHORUGRAM   
 
Admission No.
Sibling Name
 
Sibling Class
 

Student Details

Student First Name*
Student Middle Name
 
Student Last Name
Gender*
 
Date of Birth*
Admission sought in class*
 
Category
Religion
 
Nationality
Blood Group
 
Email
Mobile No.*
 
Student Type*
Aadhar No.*
 
Student's Photo (Max-2 MB)
 

Permanent Residential Address

H No/VILLAGE/WARD*
 
Post
 
Country
District/City*
 
State*
Pin Code*
 

Correspondance Address (Check this box if Permanent Residential Address & Correspondance Address are same.)

H No/VILLAGE/WARD
 
Post
 
Country
District/City
 
State
Pin Code
 

Father's Details

Father Name*
Qualification
 
Occupation
Organization
 
Designation
Annual Income*
 
Phone(Off.)
Address(Off.)
 
E-mail
Mobile No.*
 
Nationality of Father
Pan No.
 
Father's Photo (Max-2 MB)
 
 

Mother's Details

Mother Name*
Qualification
 
Occupation
Organization
 
Designation
Annual Income
 
Phone(Off.)
Address(Off.)
 
E-mail
Mobile No.*
 
Nationality of Mother
Pan No.
 
Mother's Photo (Max-2 MB)
 
 

Local Guardian Details

Guardian Name
Guardian Address
 

Additional Detail's

Last Class*
Last School Name*
 
Whether the last School was CBSE affiliated?*
 
 
 
Marks Obtained*
Total Marks*
Percentage*
 
Subject proposed to offer :
1. 2.
3. 4.
5. 6.
 
TC No
TC Date