Name of the Pupil

Sex

Male Female

Date Of Birth

Nationality

Religion

Community

Caste

Father's Name

Mother's Name

Father's Occupation with Official Address

Mother's Occupation with Official Address

Permanent Address

Landline No.

Parent's Mobile No.

Name of the School Previously Attended

Medium of Instruction

Name of Qualifying Examination

Reg. No. and Year of Passing X Std.

Aggregate Marks / CGPA Percentage

Stream Preffered

Optional

I hereby state that details furnished above are correct.

I undertake to abide by the Rules of the School.