DAV-SM Fomra School - Kelambakkam

Fomra Nagar, Rajiv Gandhi Salai (OMR), Kelambakkam, Chennai - 603 103
Application for Admission
Application No : DAV-SM/00568/2324

STUDENT DETAILS

1 . Name of the student : Dhanasvi T

2 . Gender : -
3 . Class For which admission is sought : IV
4 . Date of Birth : 19-01-2015
5 . Preferred Language1 : English
6 . Preferred Language2 : Hindi
7 . Nationality : Indian
8 . Religion : Hindu
9 . Community : OC
10 . Mother Tongue : Telugu
11 . Blood Group : O +ve
12 . Personal Identification I : -
13 . Communication Mobile No : 9841932795
14 . Student's Aadhaar Number : 891023854004
15 . Personal Identification II : -
16 . Communication Email Id : sureshkumartungala@gmail
.com
17 . Any existing Illness : No

FATHER'S DETAILS

1 . Father's Name : Suresh Kumar T

2 . Father's Qualification : Under Graduate (Bachelor's)
3 . Employer : Software Engineer
4 . Father's Designation : Assistant Consultant
5 . Father's Mobile No : 9841932795
6 . Father's Email Address : sureshkumartungala@gmail
.com
7 . Father Annual Income (or) Monthly Income : 5,00,000 and above
8 . Father Organization Name : Tata Consultancy Servce
9 . DAV Alumnus : No
 MOTHER DETAILS

1 . Mother's Name : Lavanya T

2 . Mother's Qualification : Post Graduate (Master's)
3 . Employer : Home Maker
4 . Mother's Designation : Home Maker
5 . Mother's Mobile No : 9841932795
6 . Mother's Email Address : lavanyasuresh06@gmail.co
m
7 . Mother Annual Income (or) Monthly Income: -
8 . Mother Organization Name : -
9 . DAV Alumnus : -

GUARDIAN DETAILS

1 . Guardian First Name (or) Guardian Full

Name : -
2 . Guardian Mobile No : -
3 . Guardian Email Id : -
4 . Guardian Annual Income (or) Monthly
Income : -

COMMUNICATION (OR) RESIDENTIAL DETAILS

1 . Permanent Address : F2 Plot.2 Soorathamman

koil 2 Street Peerkankarani
2 . Residential Address : F2 Plot.2
Soorathammankoil 2nd
Street Peerkankarani
3 . City : Chennai
4 . Pincode : 600063
5 . City : Chennai

PREVIOUS STUDIES (OR) PREVIOUS SCHOOL DETAILS

1 . Last Studied Class : III

2 . Second Language : Hindi
3 . Third Language : Tamil
4 . Previous School name : San Academy
5 . Address of the school : Near outer Rung Road
 Tambaram
6 . Board : CBSE

EMERGENCY CONTACT DETAILS

Name Relationship with child Contact No Address

- - - -

EXTRA CURRICULAM ACTIVITIES (OR) ACHIEVEMENTS DETAILS

Name of the School Name of the Activity Level of Participation

- - -

SIBLING DETAILS

1 . Student's Sibling is studying in our Group of

Schools : -

OTHERS DETAILS

1 . Do you wish to Avail School Transport : Kelambakkam

2 . EMIS Number : -

DOCUMENT UPLOAD DETAILS

1 . Student's Birth Certificate : Attached

2 . Transfer Certificate : -
3 . Student Image Upload : Attached
4 . Family Photo Upload : -
5 . Student Aadhar Card : -
6 . Sports or Co-curricular Certificate 1 : -
7 . Address proof Certificate : Attached
8 . Community Certificate : -
9 . Employee certificate/Employee ID Card : Attached
DECLARATION
I declare that the information given below is correct , and that no alteration in the Name, Date of Birth ,
Community will be asked for in future on the plea that it was not given correctly at the time of admission.

Station : Signature of Father :

Date : Signature of Mother :