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SAGAR PUBLIC SCHOOL

Saket Nagar, Bhopal


Ph: 0755-2489601-04
e-mail: spsbhopal@gmail.com

REGISTRATION FORM
Form No. :

Academic Session:

Affix a
recent coloured
Photograph
of the candidate

Admission in Class:
Students Name (IN BLOCK LETTERS)

First Name
Date of Birth: ( In figures ) D

Middle Name
M

Surname

( In words )_______________________________________________________________________
Place of Birth: City ________________ Gender of the Child : MALE / FEMALE
Nationality __________ Religion ____________Mother Tongue ________Category G SC ST OBC

(Submit valid
Caste certificate)

Local Residential Address_______________________________________________________________________


_____________________________________________________________________________________________
Name of the last School attended ____________________________________________City _________________
Attended From _________________ To _____________________ Reason for leaving ________________________
Last class attended ____________________ Result ________________________ Percentage obtained __________
Area of Interest:

Art/ Craft

Music

Sports

Any Other ___________________

Allergy / Any serious ailment ( if any) :______________________________________________________________


Fathers/Guardians name:

First Name

Middle Name

Surname

Educational Qualification: __________________________________________________ Age __________________


Fathers Occupation & Designation _______________________________ E-mail Address _____________________
Telephone No.(Office) _________________ (Residence) ______________________ Mobile No.________________
Mothers Name :

First Name

Middle Name

Surname

Educational Qualification: ___________________________________________________ Age _________________


Mothers Occupation & Designation __________________________________ E-mail Address _________________
Telephone No.(Office) _____________________ (Residence) ______________________ Mobile No.____________
Annual income of Parent(s) _____________________________________________________________________

Permanent Address ___________________________________________________________________________


_____________________________________________________________________________________________
Parents contribution: I will be delighted to help the school in the following field:
Field of interest : Academics/ Communication Skill / Personality Development / Sports / Music / Dance / Magazine/ Art
& Craft / Dramatics / Horticulture / ________________________________________________________________
Any Brother / Sister studying/applying for admission (If yes) Name ___________________________ Class _____
If NO: Name_________________________________ class _____ school__________________________________
School bus facility required :

Yes

No

We certify that the information furnished in the form is true to the best of our knowledge. We hereby agree to abide by
the rules and regulations of the school.
Date :
Mothers Signature

Fathers/Guardians Signature

FOR OFFICE USE ONLY


Reg. No_________ Date of Interview / Test ________ Time _______ Result _____ Marks ______
Admitted in Class _______________ on date ____________ Scholar No. ___________________
Submitted Transfer Certificate/Birth Certificate

Yes

No

Submitted Photocopy of Mark sheet of previous class

Yes

No

Approved and admission granted by : __________________________


Readmitted in class _________________ on _______________ Scholar No._________________
Recommended by _______________________ Provisional / Undertaking ___________________

Prepared / checked by

Principal / Headmistress

FEE DEPOSIT DETAILS


Deposited Admission fee & Caution money Rs. _______________________
By Cash / Cheque No. _________________ Date _____________________
Accountant
HAVE YOU ATTACHED?

Attested photocopy of birth certificate with name issued from municipal corporation ( For Nursery Class I )

Two recent passport size photographs of the child

Original Transfer Certificate, counter signed by the competent educational authority ( Class II onward)

Attested copy of Mark Sheet of previous class (Class I onward)

Attested copy of Caste certificate. ( If applicable)

Administrative Officer
Remarks

I hereby agree that admission will be treated as provisional till all the required documents have been submitted.
Signature of Parents

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