PUSHKARA PUBLIC SCHOOL
Affiliated to CBSE Board,New Delhi.
Application Form
Primary
Secondary
Middle
Student Name
Admission Number
GENDER
--Select--
Male
Female
DATE OF BIRTH
( A Copy of Original Birth Certificate to be attached)
COMMUNITY
--Select--
BC
MBC
OC
SC
ST
others
RELIGION
--Select--
Hindu
Muslim
Christian
This Information is intended only for statistical purposes (Copy of Certifiacte to be attached)
CLASS TO WHICH ADDMISSION IS SOUGHT
--Select--
L.K.G
U.K.G
CLASS I
CLASS II
CLASS III
CLASS IV
CLASS V
SECOND LANGUAGE
--Select--
Hindi
Tamil
NAME OF THE PARENT / GUARDIAN
Email OF THE PARENT / GUARDIAN
OCCUPATION
MONTHLY INCOME
PHONE
FULL ADDRESS (Any change should be intimated immediately)
MOTHER TONGUE
--Select--
Hindi
Tamil
Telugu
English
SCHOOL IN WHICH LAST STUDIED
(Attach the Original TC )
(Attach the Conduct Certificate)
BLOOD GROUP
WHETHER HE / SHEHAS BEEN VACCINATED AND INOCULATED
WHETHER SCHOOL TRANSPORT IS REQUIRED, IF YES, BOARDING POINT
NAME OF BROTHER/SISTER IF ANY, IN SDR SCHOOL WITH GRADE
STATION
DATE
SIGNATURE OF PARENT/GUARDIAN :
Submit
