PLEASE READ THE FOLLOWING INSTRUCTIONS CAREFULLY BEFORE FILLING UP THE REGISTRATION FORM:
Student's Image
*
Mother's Image
*
Father's Image
*
CHILD FIRST NAME:
Enter First Name
CHILD MIDDLE NAME:
CHILD LAST NAME:
APPLIED FOR CLASS:
--Select--
NURSERY
PREP
Select Class
CATEGORY (TICK WHICHEVER IS APPLICABLE):
GENERAL
SC
ST
OBC
GENDER:
BOY
GIRL
Select Gender
DATE OF BIRTH:
Enter Date Of Birth
FATHER'S NAME:
Enter Father Name
MOTHER'S NAME:
Enter Mother Name
RESIDENTIAL ADDRESS (PERMANENT):
Enter Residential Address
MOTHER'S MOBILE NO.
FATHER'S MOBILE NO.
Enter Phone Number
HOME (LANDLINE).
OFFICE (LANDLINE).
MOTHER TONGUE:
Enter Language
SIKH MINORITY:
YES
NO
Select One Option
DISTANCE FROM SCHOOL:
0-2 KM
2-4 KM
4-6 KM
6 KM ABOVE
Select One Option
SCHOOL ALUMNI (ONLY CLASS XII PASS FROM DASHMESH PUBLIC SCHOOL ANY BRANCH)
YES
NO
Select One Option
A) ADMISSION NO.:
B) ALUMNI NAME:
C) YEAR OF PASSING:
SIBLING:
YES
NO
Select One Option
A) ADMISSION NO.:
B) NAME OF CHILD(SIBLING):
C) CLASS/SEC:
D) FATHER NAME:
E) MOTHER NAME:
SINGLE PARENT:
YES
NO
Select One Option
STAFF WARD(ONLY VIVEK VIHAR):
YES
NO
Select One Option
A) EMPLOYEE ID:
B) NAME:
C) DESIGNATION:
MEDICAL INFORMATION:
DOES THE CHILD HAS SPECIAL MEDICAL NEEDS:
YES
NO
Select One Option
IF YES GIVE DETAILS
TRANSPORT:
IS THE SCHOOL TRANSPORT REQUIRED?
YES
NO
(TICK WHICHEVER IS APPLICABLE)
Select One Option
Agree and Continue
Required*