Name of the Pupil (Block Letters)^* :

Date of birth^* :

Age^* :

Gender :

Mother thoung^* :

Nationality:

Religion:

Cast:

Standard to which admission is sought:

Name of guardian:

Mode of travel:

Vehicle point:

Name of Father :

Edu. qualification :

Occupation :

Tel No. :

Name of Mother :

Edu. qualification :

Occupation :

Tel No. :

Siblings (If any) :

Adress :

Academic Year :

Class^* :

TC No:

Date of admission:

Date of leaving remarks:

Identification marks:

I here by declare that the date of birth my son/daughter/wards shown in the application is true to the best of my knowladge and beliefe and that he/she will abide by the rules and regulations of the institutuin.