Documents Required:- Date 3, y .

2~
l. Xerox of the Birth Certificate from Nagar Parisad~
2. Xerox copy of the last Report Card of the school. ,®
KG 3. Original T.C. from the last school attended (for grade Jr. KG to
' ·L
1
IX, XI). •
:& 4. Proof of residence, Xerox Copy of Aadhar Card of Parent &
Child for whom admission is sought. , im Chaven deda
I

•.s. 5. Attested copies ofparenfs highest educatio

I nal qualifications. in

6. Student's passport size coloured photos (4). Recent

7. Parents Pas~port size coloured photo (2 each). Passport Size
block letters Photograph
of 1he Student
Result Size 35 rrm x45 rrm

No. : 1730955 J
. _ __ _ _ __ J

Coordinator's Sign Principal's Sign .

Name Surname

'I~'A. . . .D_I
......,._I IIt IR I I I I I I I
I A_..__I---L..I--LI__,JI I G; I, 2 IR ,
~'--'-'-1
__I ~.. ____._,-=-fl__.__f'\....__ID_,_____;
Father's Name Mother's Name

__ _IJ___
IR_IA sl~H- ._I_I_I_..__I---L..l-'-1__,I lglH l~lb l Yl~I I I I I I I
IE_._l__

0l..J.-IR--A-1~~1--~l_·R._I~I_._I_..__I---L..1--Ll__,I lclH lvlr l~IA I

._____IG_ I I I I I I

Date of Birth
(In figures) (In words)

I 0121 olsl ~1011 lgll,-~~J~IM--r-lA--"TI-Y.----l1--r-·lw~lo---rl-1--1H-·b---uls--·M-NA-----J1q~~-Iu-.

Place of Birth Nation ality

I :J I O Ip I H I p I l) I R. I I I I I I II,- --I -r-1 A-----1N---1-1-1 -1-1

l --,--I
A:--r--1D----1
Applying for Grade
Aadha r Number of Pupil
1·1 I I I I I I I I I I
I I I I I I I I
Gender
Caste
Gener al D OBC I j SC D • CJ ·····sr

Board in the last school - CBSE RBSE ICSE

Name, Addre ss & Medium ofinst ructio of the l~ school

Resid ential Addre ss M-li. 1 -vtWX • ,kw ~, ·-

0.1~:... An:.f- HA!flikJ q •• [_- - - - ~ - • •
_n__cei..=r--~~~~-=-------
I
0
1\. K l Jttl}J

_ _ _ _ _ _ _ __
Perma nent Addre ss (In case of transf erable Job only) _ _ _ _ _ I

j
 Father Mother

Educational Qualification '"P&&t r,.o.A»J.f... Cl>'l'ls I

Medium of Instruction ~-
Occupation ~~c%~c~) fJ~cr
Monthly Income l·S~
Mobile No.

~mail ID @~au~~ ½Qo®1;.wr,,.,...;;;....___ _ __

: !adhar No. 4ll 38 8 69 I JI oI q l I 3 l q 7 S- 2->2-
Minority Group CHRISTIAN D SIKH D MUSLIM D
PARSEE D JAIN D OTHERS D

Personal Health Record of the Pupil

Details of any serious illness during the last three years (if any} _ _ _ _ _ _ _ _ _ _ _ _ _ __

Blood Group _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

I declare that the information given above is correct to the best of my knowledge.

I have read the rules and regulations formulated by the management and agree to abide by them.

(Signature)
Mother Guardian
(if any, other than parents)

Date: _ _ _ _ _ __
Principal's Signature
Documents required/or confirmed admission
Note: You are requested to attach the following documents at the time ofadmission.
1) Xerox ofthe Birth Certificatefrom Nagar Palika.
2) Xerox copy ofthe last Report Card ofthe student.
3) Original T. C. from the last school attended {for grade Jr. KG to VIII).
4) Proofofresidence, Xerox Copy ofAadhar Card ofParents & childforwhom admission is sought.
5) Attested copies ofparents highest educational qualifications.
6) Students passport size coloured photos (4)
7) Parents Passport size coloured photo (2 each)
N.B. : School Leaving Cetti.ficate of students coming from other states and abroad
must be counter signed by the respective Education Department.