A.Y.

: 2022 - 23
PAWAR PUBLIC CHARITABLE TRUST'S Sr. No. : NC-10888
Std : 2
PAWAR PUBLIC SCHOOL
Nanded City, Sinhagad road, Recent
Pune - 411041. Passport size
Ph.: 67506111 Fax : Website : www.ppsnandedcity.com photo must be
affixed here
APPLICATION FORM FOR REGISTRATION before seeking
FOR ADMISSION

Student Name : Master Kamble Dhairyasheel Mayur

Last Name First Name Middle Name
Sex : Male Mother Tongue : Marathi Place of Birth : Pune Nationality : Indian

Date of Birth : 08/Aug/2014 8 8 2014

(in words) (Date) (Month) (Year)
Religion : Hindu Caste : Chambhar Category : SC
Standard to which admission is sought : 2 Aadhar Card No. 718386682800
Name of the School and Standard in which the child is studying at present -
School : City international school Std : 1st

Put a þ on ¨ ICSE þ CBSE ¨ SSC ¨ OTHERS ( þ recognised ¨ not recognised )

Father's / Guardian's Name : Kamble Mayur Murlidhar Age : 39 years
Surname Name Father's Name
Mother's Name : Kamble Yogita Mayur Age : 35 years
Surname Name Husband's Name
Residential address of Parents : Bageshree tower E 7th floor flat no 705/706 nanded city sinhagad rd pune 41, Pune,
Maharashtra
Pin Code : 411041 Living Location : Nanded City Mobile 1: 9168792846
Tel.: (Res.) (Off.) Mobile 2: 7507895577 Email : kamblemyogita@gmail.com
þ
Please answer against the relevant category / categories.(Put a þ on YES / NO )

SIBLING DETAILS :

Sr. No. Student Name Father's name Mother's name Standard. Div.
1 - - - - -

Are you seeking admission for any other child/children of your own? If yes, fill in the following details :

Sr. No. Surname Name Father's name Std. Form No.

LIST OF SUPPORTING DOCUMENTS :

1) Two Photographs
2) Copy of Birth Certificate (Nursery - Std. I)
3) Residence Proof
4) Copy of Mark Sheet / Progress Report
5) Original Leaving Certificate (Std. II and Above)
6) Fitness Certificate from Registered Medical Practitioner
7) Copy of Caste Certificate (Optional)
8) Copy of Passport / PIO card (for students travelling from outside India)
NOTES :

1) Original Documents to be produced for verification at the time of admission.

2) Forms will NOT be accepted if they are incomplete, without the supporting document or if original documents are not
produced for verification.
3) If the pupil has come from a different District / State, other than Pune district, the Transfer Certificate must be
countersigned by the appropriate Inspector concerned.
4) If the pupil has come from a different country, other than India, the Transfer Certificate must be countersigned by
the appropriate officer of the Indian Embassy / Consulate / High Commission in that country concerned. Documents
without this stamp will not be accepted and the admission will be provisional (up to 2 months), subject to the parents
providing the said documents.

Areas in which you would like to participate in the Parent - Teacher Association. Please indicate by a þ

¨ Celebration ¨ Newsletter and Publicity ¨ Co-curricular Activities

¨ Computer / Software ¨ Excursions and Visits ¨ Sports

INFORMATION ABOUT THE PARENTS

FATHER MOTHER

1. Name : Mr. Kamble Mayur Murlidhar Mrs. Kamble Yogita Mayur

2. Educational Qualification : BE Mech Msc microbiology

3. Mother Tongue : Marathi Marathi

4. Other Languages Spoken : Marathi hindi english

5. Religion : Hindu Hindu

6. Occupation : Other

Profession / Business (give details)

a) Name of the Company/Organisation : Mmsi co ltd

b) Designation / Type of Business : Shipping

c) Office Telephone no :

d) E-mail Address : kamblemyogita@gmail.com

e) Fax Number :

We assure the school that the information provided by us above is true and accept that if any of the information
is found to be incorrect in any way the school has right to cancel the admission.

Fill in the address for correspondence & bus pick up in given format only.

Date : 21-Feb-2022
Signature of Father Signature of Mother

Admission Co-ordinator : Online

Remark :

Date : Principal's Signature :

 PAWAR PUBLIC SCHOOL
A.Y. : 2022 - 23 Sr. No. : NC-10888

Student Name : Master Kamble Dhairyasheel Mayur Admission to class : 2

We acknowledge receipt of the duly filled admission form.

Date : Sign. :

Please attach the Results of prior year, compulsory for students seeking admission for STD I to X.