Online Registration Form 2012 - 2013

Name of the child(in block letters) *
Gender * Boy Girl
Date of Birth * DD / MM / YYYY
Date of Birth(in words) *
Admission sought in Class *
Age as on 31st March 2012*
INFORMATION ABOUT PARENTS
Father's Name(in block letters) *
             Contact Number
             Email
Mother's Name(in block letters) *
             Contact Number
             Email
Guardian's Name(if any)
Residential Address *
Pin Code *
Contact Number *
ADMISSION PARAMETERS
Distance from School * Within 5km 8km 10km 15km beyond
Do you require school transportation? * Yes No
First Child * Yes No
Girl Child * Yes No
Real brother / sister studying in this school * Yes No
If Yes, Give details
Name 1
Class and Section
Name 2
Class and Section
Are any of the parents Alumni of this School?
Father Yes No If Yes(year of passing)
Mother Yes No If Yes(year of passing)
Transfer from other state(Father / Mother / Guardian) * Yes No
If Yes, please specify the state / country
ADDITIONAL INFORMATION
Any other additional information that you would like to provide/ Any medical conditions that require special attention
UNDERTAKING  
I * * Father Mother Guardian of *
hearby declare that the information given above by me is based on facts and authentic records.
Admission of my child may be cancelled if any information is found to be false.