ADMISSION FORM FOR NURSERY – CLASS VIII Please read carefully before filling the form. 1. Seeking admission to class (required) 2. Full name of the student (Leave a blank between the First name, Middle name and Surname) (required) 3. Date of Birth: (required) 4. Sex: (required) ---MaleFemale 5. Religion 6. Nationality 7. Tribe/Caste 8. Category: ST/SC/OBC/General 9. Previous examination details Class Year Name of the School Board Roll No % of Marks 10. Father's name 11. Father's designation 12. Mother's name 13. Mother's designation 14. Legal Guardian's name (When either father or mother is not the guardian) 15. Legal Guardian's name designation 16. Permanent address 17. Present address 18. Contact Number (Mobile/phone) (required) 19. Will you avail School-Bus service Yes/No YesNo If yes mention your pick up point: 20. CSA (Pick any one) Co-Scholastic Activity: ---MusicTaekwondoFine ArtsDance" ADDITIONAL INFORMATION Statement regarding Physical health (a) Have you suffered or is suffering from any of the following : (i) Heart Problem: ---YesNo (ii) Kidney / Urinary: ---YesNo (iii) Disease of nervous system: ---YesNo (iv) Have you had an ECG / X-ray: ---YesNo (b) (i) Height in Cms (without shoes): (i) Weight in Kgs: DECLARATION I the parents/Guardian of the applicant do hereby declare that i have checked and verified the particulars given above are true to the best of my information and belief.