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18 views2 pages

nios-form

Uploaded by

huhkloui
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
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Behind SAP Labs, Seetharam Palya, Basavanagar, Bangalore - 560 048, INDIA
Ph: 080-40936034,42184340
•[email protected]• www.gopalanschool.com

NIOS

APPLICATION FOR ADMISSION TO CLASS____________

Academic year___________ Admission No:_____________

Student Information
Name (IN CAPITAL LETTERS) : ____________________________________________

Date Of Birth : __________________________________________________

Gender * Male Female

Place Of Birth : __________________________________

Nationality : _____________________________________

Language/s (spoken at home) :___________________________________________

Nature of Special needs / Diagnosis * :_________________________________________

:_________________________________________

Medical issues that requires special attention (Asthma, Allergies) *


:________________________________________________________________

Particulars of previous schooling *


:________________________________________________________________

Parent Information
Name of the Father : ________________________________________

Nature of work / Business : ________________________________________

Place of Employment : ________________________________________

Name of the Mother : ________________________________________

Nature of work / Business : ________________________________________

Place of Employment : ________________________________________


Language

English
Kannada
Hindi

Subject
1. …………………………..

2. …………………………..

3. …………………………..

4. …………………………..

5. …………………………..

Details For Communication


Mobile number (Father) : _______________________________________

Email-id of Father : _______________________________________

Mobile number (Mother) : _______________________________________

Email-id of Mother : _______________________________________

Residential Address * : _______________________________________

_______________________________________

_______________________________________

_______________________________________

Documents to be enclosed.

● Copy of the Birth certificate of the student, Progress Report & Aadhaar Card
● Copy of the transfer certificate issued by the school last attended *

Signature of Mother

Signature of Father

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