DELHI PUBLIC SCHOOL, GBN

Under the aegis of The Delhi Public School Society, New Delhi
B-1, Sector-132, Expressway, Noida-201301

Student Card Escort Card Both Cards

Student
Kindly paste Father Mother Escort - 3 Escort - 4
the recent
photograph
in
summer school
uniform

STUDENT INFORMATION FORM (To be filled by Parents/ Guardian for I-Card IN CAPITAL LETTERS ONLY)
Dear Parent, kindly read the following instructions carefully before filling up the information slip.
1. All information is to be filled in CAPITAL LETTERS ONLY. It would not be accepted otherwise.
2. KINDLY AVOID OVERWRITING. In case there is a mistake, cut the entire word/ number and then write it again.
3. In case parents are not sure about any detail (Like Admission No.), kindly instruct your ward to confirm it with his/ her Class
Teacher before submitting the form. Please note that the form would be processed as received.
4. It is mandatory to fill all the details.

Admission No. :
Name of the Student :
Class/ Sec (To be filled by the Class Teacher):
Date of Birth : Blood Group :
Aadhar Card No. (Child) :
Father’s Name : _________________________________ Occupation:_______________________

Office Address : _______________________________________________________________

Father’s Contact Details : Mobile __________________E-mail:______________________________

Mother’s Name : _________________________________ Occupation:_______________________

Office Address : _______________________________________________________________

Mother’s Contact Details : Mobile __________________E-mail:______________________________

Residential Address : _______________________________________________________________

City: ___________________ Pin Code:_______________State:_________________

Emergency Contact No. : ___________________________________________

Mode of Transport : (Private Escort/School Bus)_____________________________________________

Bus route no. (if applicable) : Morning : ____________________ Afternoon : _____________________
Bus Stop : Morning : ____________________ Afternoon : _____________________
Sibling (if in this school) : Yes/No ______________
Name and class of the Sibling :
(if no sibling then kindly write N/A) : ______________

Parent’s Signature Transport I/c Signature Class Teacher’s Signature Co-ordinator Signature