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Name of Pupil
*
Gender
*
Male
Female
Father's Name
*
Mother's Name
*
Identification Mark 1
*
Identification Mark 2
*
Name and Address of Parent or Guardian
*
Relation of Parent/Guardian
*
Occupation of Parent / Guardian
Name, Address and Occupation of local guardian. In case the Pupil Does not live with his/her parents
School previously attended with dates
Particulars of Birth Certificate
Age on date of application(In Words) (Number of years and completed months should be given)
Nationality and state to which pupil belongs
*
Community and Religion
*
Does the Candidate belongs to Scheduled Castes of Scheduled tribe or other backward communities or is he/ she a convert from Scheduled Castes or Scheduled Tribe
Standard to which admission is sought(in words)
*
Mother tongue of the pupil
*
First Part of first Language of Pupil *
Number and Date of Transfer certificate produced on admission *
Date of Last Vaccination *
Date of Birth *
Day
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Month
January
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April
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December
Year
1992
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2011
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2015
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2018
2019
2020
2021
2022
2000
2011
2012
2013
Photo *
(Size : 160px X 180px)
I Solemnly declare that the above particulars about
are true and correct and no change in the date of birth of my ward be claimed at any future date.
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