Common Application Form for the Admission under Free ship Quota

(To be filled in Block letters)

Registration Number

Academic Session 20______ to 20________

Economically Weaker Section
Disadvantaged Group
(Please Tick whichever is applicable )

1. Name of the School:_______________________________________________________________

(with address)

2. Name of the Child:________________________________________________________________

3. Sex:

Male

Female

4. (a)Date of Birth* (in words) Day

Month

Year

5. Age as on 31.03.2012 :_____________________________________________________________

(in words)

6. Mothers Name:__________________________________________________________________
7. Fathers Name:___________________________________________________________________
8. Guardians Name:_________________________________________________________________
9. Profession of the parents:
a. Mother:__________________________________
b. Father: ___________________________________
10. Present Residential Address**: ______________________________________________________
11. Phone No. of the Parents/Guardian:___________________________________________________
a) Mobile No.:______________________________________________________________________
b) Landline No.___________________________________________________________________