To which class admission is needed * VVIIIXI Email ID for Correspondence * Student Detail Student Name * Date of Birth * Place of Birth * Nationality * Father's Detail Father's Name * Qualification * Profession * Monthly Income * Mother's Detail Mother's Name * Qualification Profession Monthly Income Religion & Caste * Community * Mother Tongue * Siblings Brother / Sister studying in same school Date of Birth Class Previous Academic Record School Place Class No.of Years First Preferred Group Group A - Physics, Chemistry, Biology, MathematicsGroup B – Physics, Chemistry, Computer Science, MathematicsGroup C - Business Studies, Accountancy, Economics, Computer Science Second Preferred Group Group A - Physics, Chemistry, Biology, MathematicsGroup B – Physics, Chemistry, Computer Science, MathematicsGroup C - Business Studies, Accountancy, Economics, Computer Science Address Residential Address * Mobile (Residential) * Phone (Residential) Father's Office Address (Father's) Office Address Mobile (Father's) Phone (Father) Mother's Office Address (Mother's) Office Address Mobile (Mother's) Phone (Mother's) Declaration I declare that the information and particulars furnished above are true to the best of my knowledge.In the event of my ward being admitted in the school, I agree to abide by all the rules and regulations of the school. Place * Date* BackNext Health History Form Emergency Phone Number * Blood Group * O-O+A-A+B-B+AB-AB+ Physician Physician to be called in an emergency Address Phone Guardian / Relative Guardian / Relative to be called in an emergency Address Phone Has your child ever had the following illness? , If so, When? Name Date Chickenpox Yes Measles Yes Diphtheria Yes Malaria Yes Heart Disease Yes Serious Injury Yes Others Name Date Epilepsy Yes Tuberculosis Yes Ear Condition Yes Asthma Yes Allergies Yes Operation Yes Has your child ever had the following protective measures? , If so, When? Name Date BCG Vaccination Yes Polio Yes Name Date Tetanus Yes Hepatitis A & B Yes Date of last physical check-up
