INT :- .................

DELHI PUBLIC SCHOOL JALANDHAR
GT ROAD
, JALANDHAR CANT T - 1440010


Telefax: - 241343 6- 37. Email: - info@dpsjalandhar.com
Website: - www.dpsjalandhar.com

 

 

REGISTRATION FORM

(Issue of Registration Form does not imply admission, as seats are limited)

 

* indicates mandatory fields

Please Register name of my Son / Daughter /Ward for admission to your school.

 

 

 

 

 

 

1

* Admission sought to: Class:

Session

2013-14

 

2

* Child ' s Name in full (BLOCK LETTERS)

 

 

 

3

* Date of Birth ( in figures an d in words)

 

 

 

 

* Age as on 1 st April 2013

Years

 

 

 

Months 

 

 

 

Days.

 

 

 

 

 

 

 

4

* Nationality of child:

* Religion:

 

 

Mother Tongue:

* Home Town

 

 

* Place of Birth:

* Whether SC/ST (YES/NO) 

 

 

 

 

 

 

 

5

* Father ' s Name (Block Letters):

 

 

 

 

* Academic Qualification:

* Occupation:

 

 

* Religion: 

 

 

 

 

Designation

 

 

 

 

Name of the organization / firm

 

 

 

 

Office Address :

 

 

 

 

* Phone

(O)

 

 

(R)

(M)

 

 

* Email

 

 

 

 

 

 

 

 

 

6

* Mother ' s Name ( Block Letters):

 

 

 

 

* Academic Qualification:

 

 

 

 

Occupation:

Designation

 

 

Name of the organization / firm

 

 

 

 

Office Address :

 

 

 

 

Phone

(O)

 

 

(R)

(M)

 

 

 

 

 

 

 

7

Guardian's Name (Block Letters):

 

 

 

 

Occupation:

Designation

 

 

Name of the organization / firm

 

 

 

 

Office Address :

 

 

 

 

Relationship with child:

(O)

 

 

Phone

(M)

 

 

(R)

 

 

 

 

 

 

 

 

8

Particulars of siblings studying in DPS Jalandhar ,

 

 

 

 

Name:

Class:

 

 

Name:

Class:

 

 

 

 

 

 

 

9

*Address (Permanent)

 

 

 

 

* (Present) :

 

 

 

 

* PIN

 

 

 

 

 

 

 

 

10

Details of the present school being attended ( if applicable ):

 

 

 

 

Name:

 

 

 

 

Class:

 

 

 

 

Position obtained in last examination:

 

 

 

 

Pro f iciency in games / c o - curricular /outstanding achievements ( enclose certificates , if any)

 

 

 

 

Details of marks obtained in last annual exam. ( in % )

 

 

 

 

English

Hindi

%

 

 

3 rd Language

%

Math's

%   

 

 

Science

Social Studies

%   

 

 

Any Other Subject

%

 

 

 

 

 

 

 

 

 

 

NOTE :

Please bring the attested Photocopy of Munciple Birth Certificate & two Passport Size Photographs at the time of admission test

 

 

 

 

 

 

 

 

Date :

 

 

 

 

Place:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

 

For Office Use Only:

 

 

 

 

Test On :................................................... Admission number: ................................. Class : ........................................

Recommendation of the Principal / Management / Selection Committee :............................................................................

Principal's Signature : ..................................................................................................................................................

Transfer Certificate: Received / Not Received

If received , TC No: ...................................... Date :................................................... School : .....................................