Candidate's Full Name

Class (Admission Sought)

Mobile Number

Date of Birth (Figures)

Date of Birth (Words)

Mother Tongue

Religion

Caste/Category: GEN/SC/ST/OBC/BPL

Sub Caste

Father's Name

Father's Educational Qualifications

Father's Occupation

Father's Annual Income

Father's Phone/Mobile Number

Mother's Name

Mother's Educational Qualifications

Mother's Occupation

Mother's Annual Income

Mother's Phone/Mobile Number

Contact Email

Full Address (Permanent)

Student's Bank Account Number

IFSC CODE

Student's SSSMID No.

Student's Adhar Number

Suffer from any Disability (As per RTE Rules) Suffer from any Disability (As per RTE Rules) Yes No

Blood Group of Student

Any Disease

Any Allergy

Any Regular Medicine

Name of Previous School

Place of Previous School

Board (CBSE/STATE/Other)

Class Passed

Year Last Class Passed

Percentage

Division

Medium of Instruction

Parent Declaration Parent Declaration I certify that the information given overleaf is correct. Should any of it be found incorrect, I agree to accept any decision of school authorities arising there of including cancellation of admission or expulsion of my ward from the school.