APPLICATION FORM FOR THE SESSION 2024-25
*All Fields are Mandatory
1. Name in full (
As given in your Certificate
)
*
2. Father's Name
*
3. Mother's Name
*
4. Date of Birth(DD/MM/YY)
*
--Select Date--
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
--Select Month--
01
02
03
04
05
06
07
08
09
10
11
12
--Select Year--
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
5. Age as on
01/04/2024
*
6. Last School Attended
*
7. Whether Affiliated or Not
*
--Select--
YES
NO
8. Board
--Select--
CBSE
ICSE
JAC
WBBSE
BSEB
9. Address for Correspondence (
Please DO NOT Use Comma
)
C/O
LandMark/HouseNo/Flat
Street/Village
PostOffice
Police Station
City*
PIN*
STATE*
--Select States/Union Territories--
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chhattisgarh
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Orissa
Punjab
Rajasthan
Sikkim
Tamil Nadu
Tripura
Uttaranchal
Uttar Pradesh
West Bengal
Andaman and Nicobar Islands
Chandigarh
Dadar and Nagar Haveli
Daman and Diu
Delhi
Lakshadeep
Pondicherry
10. Nationality
*
11. Mobile Number
*
Whatsapp No.
Alt. Mobile Number
12. Email ID
*
13. Gender
*
MALE
FEMALE
14. Category
* ( If OBC then Write Religion)
UNRESERVED
OBC
SC
ST
PC
15. Father's Aadhar Number
*
16. Mother's Aadhar Number
*
17. Pupil's Aadhar Number
MEDICAL INFORMATION OF THE PUPIL
1. Name of the Family Doctor
*
Phone No
2. Vaccination Status
Vaccination Completed
BCG
OPV
HEPATITIS B
DPT
MEASLES VAC
MMR
TT (TETANUS)
HIV