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 : .....................................