ADMISSION FORM

* To be filled in by the Parents/Guardian [in BLOCK CAPITAL Letters]

Child's Information -

1. Name of Child's: Forename Surname
2. Other name
3. Gender: Select Male Female Weight Height
4. DOB: Age: Place of birth:
5. DOB [in words]:
6. Birth certificate from municipality/panchayat/hospital:
[please attach attested photo copy]

7. Admission sought in class whether single child: YES/NO
8. Religion: Caste: Category: General ST SC OBC
9. Name of the last school attended:
[attach original Transfer Certificate]

10. Medium of instruction in last school
11. Last exam passed: Class Year Percentage
12. Reason for leaving previous school:
13. Mobile No. 1- Mobile No. 2-
14. Full residential address:

15. Email of Parents/Guardian:
16. Name of the Father- Forename: Surname:
17. Qualification: Occupation/Designation:
18. Monthly Income: Organization where working:
19. Samagra ID No. Aadhar Card No.
20. Bank name: IFSC Code:
21. Bank A/C Number:

Does your child suffer from any disability as to vision, hearing, walking/diseases etc.
If yes, please state clearly the disability

Do you want to admit any other children in the same school ?
YES/NO

1. Name Class Age
2. Name Class Age

If Transport required yes/no: Bus Stop:
Place: Distance[k.m/m]:

Declaration

I have read the school prospectus and agree to abide by the school rules.
Date:

Child's Photograph [passport size]

Both Parents Photograph [passport size]

Signature of Parents/Guardian