Class to which admission is sought:

STUDENT PROFILE

Name:(should be as per the Birth Certificate):*
Sex: *
Male Female
Date of Birth:*
  Date of Birth In words:
Nationality:*
Religion:*
Caste/Community:*
Category (General/SC/ST/OBC/OEC/Others):*

Schools previously attended*

Name of the School:
City/Country:
Percentage / Grade in the previous class
Is there evidence of any learning disability?*
Yes No
If yes, give details:**
Any medical/physical problem that could affect normal school life?*
Yes No
If yes, give details:**
Aadhar Number:
Blood Group:

FAMILY PROFILE

Father* Mother* Guardian
Name
Nationality
Edu. Qualification
Occupation
Office Address
Annual Income
Mobile No.
Email Id
PRESENT ADDRESS* PERMANENT ADDRESS*
Address:
Place:
Post Office:
Pin code:
Telephone No:
Address:
Place:
Post Office:
Pin code:
Telephone No:
Same as present address
Names of brothers and sisters if any
studying in this school		 Class
1.
2.

Details of Registration Fee paid:

DD No.:*
DD Date:*
Bank Name:*

I * solemnly declare that the above particulars about my child are true to the best of my knowledge and correct. I shall abide by the rules and regulations of the school and agree that I shall remit the fees in time.