DPS JALANDHAR

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.

* Admission sought to: Class:

Session

2010-11

* Child ' s Name in full (BLOCK LETTERS)

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

* Age as on 1 st April 2006

Years

Months

Days.

* Nationality of child:

* Religion:

Mother Tongue:

* Home Town

* Place of Birth:

* Whether SC/ST (YES/NO)

* Father ' s Name (Block Letters):

* Academic Qualification:

* Occupation:

* Religion:

Designation

Name of the organization / firm

Office Address :

* Phone

(O)

(R)

(M)

* Email

* Mother ' s Name ( Block Letters):

* Academic Qualification:

Occupation:

Designation

Name of the organization / firm

Office Address :

Phone

(O)

(R)

(M)

Guardian's Name (Block Letters):

Occupation:

Designation

Name of the organization / firm

Office Address :

Relationship with child:

(O)

Phone

(M)

(R)

Particulars of siblings studying in DPS Jalandhar ,

Name:

Class:

Name:

Class:

*Address (Permanent)

* (Present) :

* PIN

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