DASHMESH PUBLIC SCHOOL
C-BLOCK, VIVEK VIHAR, DELHI-110095
Unaided Minority School Recognised Secondary School Affiliated to CBSE
Ph: 011-35570677, 35564714, 47148254
Email: dashmeshpublicschool09@gmail.com
Website: www.dashmeshschool.com

REGISTRATION FORM FOR UKG to IX ADMISSION (2022-2023)

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

Student Image*

Mother's Image*

Father's 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:

Select Class

GENDER:

MALE

FEMALE

Select Gender

CATEGORY (TICK WHICHEVER IS APPLICABLE):

GENERAL

OBC

Select Category

DATE OF BIRTH: Enter Date Of Birth

DATE OF BIRTH (IN WORDS):

AGE AS ON (31st MARCH,2022):

PLACE OF BIRTH:

NATIONALITY: Select Nationality

BLOOD GROUP: Select Blood Group

RELIGION : Select Religion

STUDENT'S AADHAAR CARD NO. : Enter Aadhaar No.

MOTHER'S TONGUE:

FATHER'S NAME: Enter Father's Name

FATHER'S MOBILE NO. Enter Phone Number

Father's Qualification.

Father's Aadhaar No.

Father's Profession.

Father's Designation.

Father's Office address.

Father's Email.

Father's Office No.

Father's Annual Income

MOTHER'S NAME: Enter Mother's Name

MOTHER'S MOBILE NO. Enter Phone Number

Mother's Qualification.

Mother's Aadhaar No.

Mother's Profession.

Mother's Designation.

Mother's office address.

Mother's Office Number.

Mother's Email.

Mother's Annual Income

Gaurdian Image*

NAME OF GUARDIAN (Opt.).

Guardian's Qualification.

Guardian's Profession.

Guardian's Designation.

Guardian's Phone NO.

RESIDENTIAL ADDRESS (PRESENT): Enter Present Residential Address

Same as present

RESIDENTIAL ADDRESS (PERMANENT): Enter Permanent Residential Address

STATE:

HOME (LANDLINE IF ANY).

MINORITY:

YES

Select One Option

SCHOOL ALUMNI (ONLY CLASS XII PASS FROM DASHMESH PUBLIC SCHOOL ANY BRANCH)

YES

Select One Option

A) ADMISSION NO.:

B) ALUMNI NAME:

C) YEAR OF PASSING:

SIBLING OF THE STUDENTS STUDYING IN DASHMESH PUBLIC SCHOOL:

YES

Select One Option

A) ADMISSION NO.:

B) NAME OF CHILD (SIBLING):

C) CLASS/SEC:

D) FATHER's NAME:

E) MOTHER's NAME:

SINGLE PARENT:

YES

Select One Option

STAFF WARD(ONLY VIVEK VIHAR):

YES

Select One Option

A) EMPLOYEE ID:

B) NAME:

C) DESIGNATION:

MEDICAL INFORMATION: DOES THE CHILD HAS SPECIAL MEDICAL NEEDS:

YES

Select One Option IF YES GIVE DETAILS

TRANSPORT: IS THE SCHOOL TRANSPORT REQUIRED?

YES

(TICK WHICHEVER IS APPLICABLE) Select One Option

LAST SCHOOL ATTENDED:

Agree and Continue Required*

I/We hereby certify that the above information provided by me/us is correct and I/we understand that if the information is found to be incorrect or false, my ward shall be automatically debarred from selection/admission process without any correspondence in this regard. I/We also understand that the registration does not guarantee admission of my ward. I hereby give an undertaking that my ward will be attending the school, travelling by School Transport or proceeding on tours excursions or participating in other co-curricular and extra curricular activities at my own risk. I have read the rules and regulations of the school given in Prospectus I shall always abide by them.