Scribd
Upload
46 views

Registration Form - HTML

Uploaded by

mamtaofdehri
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
46 views

Registration Form - HTML

Uploaded by

mamtaofdehri
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 3

Delhi Public School Harni

Near Airport, Harni-Virod Road, Harni, Vadodara 390022


Tel:+91-9033009860 ,+91-7574092914/916,+91-9033030512
Email:[email protected]
Registration Form

Registration No.: REG.NO/25-26/341

Father Student Mother


Sibling Details
Sibling (Real Brother/ Sister) only studying in DPS Harni : YES
MAULSHREE
Admission No. : 24H/006 Sibling Name :
PATHAK
Sibling Class : VIII -- --
Student Details
Student Middle
Student First Name : KESHAV
Name :
Student Last Name : PATHAK Gender : Boy
Admission sought in
Date of Birth : 21-05-2021 NUR
Class:
RANGOLI PLAY
Current Class : NURSE Current School:
SCHOOL
Current School's U-
Nationality: Indian
DISE No:
Category : General Religion : HINDU
Aadhar No: 507401407815 Blood Group : A+
Email: [email protected] Mobile No: 9897236137
First Language
Mother Tongue : HINDI English
Prefered:
Optional Language Preferred (VI-VIII) :
Optional Language Preferred (IX-X) :
Do You Need
No Bus Stop:
Transport :
If Transport Facility not Available, would You Still Seek
Admission? :
Special Skills and Interests of Student : SPORTS
Communication Address
Address : Country : INDIA
City : VADODARA State : GUJARAT
Pin Code : 390022 -- --
Residential Address
SAVITRI SADAN, KALI ASTHAN WARD
Address : City : DEHRI ON SONE
NO.26
State : BIHAR Pin Code : 721307
Father's Details
Father Name : KAUSHAL KISHOR Organisation : ADITYA BIRLA GROUP
Occupation : JOB Qualification : M B A
Annual Income
Designation : GENERAL MANAGER HR 2500000
:
ADITYA BIRLA GRASIM INDUSTRIES,
Phone(Off.) : Address(Off.) :
MEGHASAR, HALOL
E-mail : [email protected] Mobile No. : 9045089079
Mother's Details
Mother Name : MAMTA PATHAK Organisation :
Occupation : HOME MAKER Qualification : B A
Annual Income
Designation :
:
Phone(Off.) : Address(Off.) :
E-mail : [email protected] Mobile No. : 9897236137
No. of
No. of Sons : 1 2
Daughters :
Guardian Details
Guardian
Name :
E-mail : Mobile No. :

List of documents to be submitted


1. A self-attested copy of birth certificate of the child along with original for verification. The certificate
issued by Municipal Corporation only is valid.
2. One Passport Size Photograph of Father, Mother and the child is mandatory.
3. Photocopy of Caste certificate if SC/ST/OBC along with Original for verification (If applicable).
4. Original bonafide certificate is compulsory at the time of registration.
5. Transfer Certificate of current school (compulsory for admission to classes II onwards). TC from the
previous school must be submitted within 15 days after the commencement of the academic session.
6. A copy of previous year report card / mid-term report card.
7. Original medical fitness certificate issued by MBBS/ MD doctor is mandatory.
8. A self-attested copy of Aadhar Card of the Student and both the parents along with Original for
Verification (not mandatory).
9. A self-attested copy of PAN Card / Driving License / passport of both the parents along with Original
for verification. This is required to verify the signatures on admission form.
10. In case of death of any one parent copy of death certificate is mandatory.
11. In case of separation copy of court custody papers are mandatory.
12. In case of single parent legal documents certifying the same are mandatory.
Please bring the original documents to be verified at the time of submission of the photocopies.

Declaration
One time, Non-Refundable, Non-Transferable Registration and Processing fees to be paid for
Registration confirmation.
Kindly note that the Registration does not imply admission.
Admission is subject to intraction / observation / written test whichever is applicable, submission of
correct and complete documents, availability of seats and the payment of all fees.
I have read and understood the Provisional Fee Structure (given on website) and agree to abide by it.
Confirmation of admission is subject to the parent's acceptance to fill the ECS Mandate forms for
further fees payment of wards. THIS lS A MANDATORY REQUIREMENT.

Date : Father's Signature Mother's Signature

You might also like