For Office Use Only
Reg. No. Date of Admission Admission No. :
Reporting / Joining Date :
General instruction: All entries should be filled in CAPITAL letters by the Parent.

पिता की फोटो/ Father's Photo

माता की फोटो/ Mother's Photo

विद्यार्थी की फोटो/ Student's Photo
Information of the Student Permanent Education No. :
1. Name of the Student (In Capital letters) Name as written in TC / Birth Certificate
(For Class XI admission write Name as per Class X Marksheet) Admission for Class
First Name
Middle Name
Last Name
2. Gender : Boy Girl
3. Date of Birth (in figures) [As per T.C.] Date of Birth

Date of Birth (in words)

4.Place of Child's Birth :

5. Whether the student is(Please Tick Mark) :

(i)EWS Yes/
 No
 (ii)Specially abled Yes/
 No
 (iii)Single Girl Child Yes/
 No
6. Religion : 7. Mother Tongue :
8. Nationality :
9. Category (GEN/OBC/ST/SC/NT/SBC) : 10. Aadhar Card No.:
11. Name of the Last School attended
12. Medium of instruction in previous school : Class Last Attended
PARENT’S CORRESPONDENCE ADDRESS PARENT’S RESIDENTIAL ADDRESS
Pin Code : Pin Code :
State : State :
Emergency Contact Numbers / Mobile Nos. (With Whats App)
1. 2.
Email ID 1 :
Email ID 2 :
FAMILY INFORMATION :
Father’s Detail :
Name
Educational Qualification : Nationality :
Occupation : Organisation :
Designation : Annual Income :
Office Address :
Pin Code : State :
Tel. : (O) / Mobile No. Aadhar Card No. :
Mother’s Detail :
Name
Educational Qualification : Nationality :
Occupation : Organisation :
Designation : Annual Income :
Office Address :
Pin Code : State :
Tel. : (O) / Mobile No. Aadhar Card No. :
Guardian’s Detail :
Name
Educational Qualification :

संरक्षक का फोटो/ Guardian's Photo
Occupation :
Designation :
Nationality :
Organisation :
Annual Income :
Aadhar Card No. :
GUARDIAN’S CORRESPONDENCE ADDRESS GUARDIAN’S RESIDENTIAL ADDRESS
Pin Code : Pin Code :
State : State :
SIBLING DETAILS studying in this school:
Name Gender Admission No. Year of Admission Class & Section
DETAILS OF BANK ACCOUNT (FATHER / MOTHER)
( FILL DETAILS IN CAPITAL LETTERS ONLY)
Account Holder’s Name
Account Number
Bank Name
Branch Name
IFSC Code
COMMUNICATION DETAILS
Mobile No. for receiving messages(Whatsapp) :
Father’s Email ID:
Mother’s Email ID:
I certify that the above particulars given by me are correct :

Signature of the Father

Signature of the Mother
FOR SCHOOL USE ONLY(Check list:)
  1. Photographs
    (I) Student's Photographs -12 Nos.
    (ii) Father's Photographs – 3 Nos.
    (iii) Mother's Photographs – 3 Nos.
  2. Permanent Education Number
  3. Declaration Form
  4. Transfer Certificate - Original
  5. Birth Certificate - Original for proof and a photocopy
  6. Mark Sheet of the session 2023-2024.
  7. Mark Sheet of last session 2024-2025.
  8. Student's Aadhar Card
  9. Father's Aadhar Card
  10. Mother's Aadhar Card
  11. Other Certificate (if any like – Academic, Sports, Painting etc.)
  12. Guardianship Card
  13. Affidavit by the Parents
  14. Indemnity Letter
  15. Undertaking
  16. Health Record Form
  17. Caste Certificate [IF APPLICABLE]
  18. Migration Certificate ( For Class XI admission)
Name of the Teacher/Office Staf on Duty : Signature & Date :
FOR OFFICE USE ONLY
Date :
Admitted to Class Section
(Signature of the Principal)