HIMALAYA PUBLIC SR. SEC. SCHOOL
D-12, SECTOR-7, ROHINI
DELHI-110085
Ph: 27046118 / 27052223
Email: himalaya_sms@yahoo.com
Website: http://www.himalayapublicschool.com

REGISTRATION FORM FOR NURSERY TO CLASS FIRST ADMISSION (2022-2023)

PLEASE READ THE FOLLOWING INSTRUCTION CAREFULLY BEFORE FILLING UP THE REGISTRATION FORM:

Student Image*

Mother Image*

Father Image*

Please read the following instructions carefully before filling up the Registration Form:
1. Parents are requested to fill up the form carefully. Any change in Date of Birth, Father’s name and Mother’s name later can be done only through court of law.
2. I/We certify that my son/daughter is not suffering from any contagious disease. The same will be intimated to the school in case it occurs in future during the course of study of my ward in School.
3. I/We hereby undertake to pay fees and other charges (if any) of my/our ward on time, failing which my/our ward’s name may be struck off the school rolls.
4. I/We understand that the school buses will ply only on existing routes.

STUDENT FIRST NAME: Enter First Name

STUDENT MIDDLE NAME:

STUDENT LAST NAME:

APPLIED CLASS:

Select Class

CATEGORY (TICK WHICHEVER IS APPLICABLE):

GENERAL

OBC

Select Category

DATE OF BIRTH: Enter Date Of Birth

DATE OF BIRTH (IN WORD):

AGE AS ON (1st APRIL,2022):

PLACE OF BIRTH:

NATIONALITY: Select Nationality

RELIGION : Select Religion

MOTHER TONGUE:

FATHER'S NAME: Enter Father Name

FATHER'S MOBILE NO. Enter Phone Number

Father Qualification.

Father Profession.

Father Office address.

Father Office No.

Father Income

MOTHER'S NAME: Enter Mother Name

MOTHER'S MOBILE NO. Enter Phone Number

Mother Qualification.

Mother Profession.

Mother office address.

Mother Office Number.

Mother Income

NAME OF GUARDIAN (Opt.).

Guardian Qualification.

Guardian Profession.

Guardian Designation.

Guardian Phone NO.

RESIDENTIAL ADDRESS (PRESENT): Enter Present Residential Address

Same as present

RESIDENTIAL ADDRESS (PERMANENT): Enter Permanent Residential Address

HOME (LANDLINE IF ANY).

SIBLING OF THE STUDENTS STUDYING IN HIMALAYA PUBLIC SCHOOL:

YES

Select One Option

A) ADMISSION NO.:

B) NAME OF CHILD (SHIBLING):

C) CLASS/SEC:

LAST SCHOOL ATTENDED:

LAST CLASS PASSED:

MEDIUM OF INSTRUCTION:

RESULT OF LAST EXAMINATION:

PERCENTAGE / GRADE OF MARKS OF LAST EXAMINATION:

Agree and Continue Required*

(a) Thereby declare that I am the bonafide parent of the child, I understand that rendering false or misleading information or with holding any information may disqualify the child for education in the school. (b) I know that the Registration Form does not guarantee admission as seats are limited. The Registration Fee is not refundable by the school. (c) I know that without Affidavit / Birth Certificate & Aadhar Card, admission is not valid.(d) In the event of my ward being admitted to the school.