Enquiry No :

Visitor Type : *

Visitor Date : *

Call Type : *

Class: *

Group :

Elective Subjects

Student's First Name * Max. 50 characters

Middle Name

Last Name *Max. 50 characters

Gender *

Date Of Birth*

Quota*

Mother Tongue*

Religion

Caste

Category*

Parallel Reservation

Place of Birth

Is Disable

Disable Type

Description Disability

Father's First Name*

Middle Name

Last Name *

Father's Occupation Type*

Father's Annual Income *

Father's Mobile No.*

Mothers's First Name

Middle Name

Last Name

Mother's Occupation Type

Mother's Annual Income

Mother's Mobile

Name of the last School/College Attended :

No of Examination

Aadhar Card NO.

Marks Obtained at Last Examination Class

No of Subjects

Bank A/C No.

Any Medals Scholarship Recieved By the Candidate During His/Her Previous Year Of Schooling

Total

Percentage (%)

Hobbies of the Candidate

Any Physical Mental Problem with the Child

Name of Relatives/Student Of This School

I Desire to offer Following Subjects of Class

Result Date

If Brother/Sister Reading in this School,Specify Admission No. Name Class and Section*

First Contact Person in Station Other Than Parents*

First Contact Person Contact No.*

Relation With First Contact Person

Second Contact Person in Station Other Than Parents

Second Contact Person Contact No.

Relation With Second Contact Person

If Bus Facility Required ? If Yes Submit a Separate Application Mentioning the stoppage

If Hostal Facility Required ?

Student Mobile No.

Mobile No For Sms*

Whatsapp No.

Student Email

Local Address *

Pin Code

State *

City *

Country

Select Photo *

Upload Student Aadhar Card Photo

Upload Student Birth Certificate Photo *