SARDAR DASTUR NOSHERWAN GIRLS' HIGH SCHOOL, PUNE - 411001.

APPLICATION FOR ADMISSION FOR THE YEAR 2023-24 FOR STD V (Fifth)

SECTION 1 : GENERAL INFORMATION OF THE STUDENT Color Photograph

Form No : 2023-DG5-C13
Name of the Child : Khandare Avani Milind Rehana
Aadhar Card No. : 478155655455
Date of Birth : 09/05/2013
Place of Birth : Pune, Pune, Pune, Maharastra, India
Mother Tongue : Marathi
Language Spoken at home : Hindi And Marthi
Allergy to :
Nationality : Indian
Religion / Caste / Sub Caste : Buddhism / Sc / Na
Permanent Residential Address of Parents : Kalas, Jadhav Vasti
,Nr Sai Laxmi Galaxy
PUNE - 411015 ,Maharashtra ,India
Landline Number :
Distance From Home : 1-10 km
Last School Details
Last School Name : Pragatti School
UDISE Number :
Student ID Number :
Recognition / Class / Medium / Passing Year : CBSE / 4th / English / 2022-23
Class Result : Grade
Subject Std-4 Term-1
English Less than B2
Maths Less than B2
Marathi Less than B2
EVS B2
Computer A2
Reason of transfer : Parent's Wish
Student interest in sports : Milind Khandare
Student interest in Extra-Curricular Activity : Dance And Cold Cooking
Bank Account Details of the Student : / / /
Blood Group : AB+
Is your own child in any of the Dastur school ? : No
Family Type : Joint
Parent- transferable government employee ?: No
Parent- staff member of any of the Dastur school ? : No
SECTION 2 : PARENT INFORMATION
Guardian A
Name : Khandare Milind Bhimrao
Relation with pupil : Father
Aadhar Card No. :
Education Qualification : Graduate/Diploma
Occupation : Self Employed
Name of Employer :
Address of Employer : Nr Sai Laxmi Galaxy Kalas Jadhav Alandi Road Pune
Monthly Income : 25000
Mobile1 / Mobile2 : 8380081334
Email1 / Email2 : reh_khandare@rediffmail.com
Landline Number :

Guardian B
Name : Khandare Rehana Mlind
Relation with pupil : Mother
Aadhar Card No. :
Education Qualification : Masters Degree
Occupation : Private Service
Name of Employer :
Address of Employer :
Monthly Income : 25000
Mobile1 / Mobile2 : 8888817142
Email1 / Email2 : reh.khandare21@gmail.com
Landline Number :

DECLARATION :

I hereby declare that the information provided in this form is true and accurate.
I hereby state that signing this application form implies unconditional acceptance of all the School's admission
procedures and processes, rules and regulations in force and as may be changed from time to time.
I am conscious of and acknowledge the constitutional Right of the Management to administer this minority
educational institution according to their choice, and accept their decision on admissions, favourable or otherwise
as final and binding.
I undertake not to approach any third party or try to bring influence either by letter or in person for securing
admissions.
All decisions taken by the Admission Committee will be final and binding.

Date:
Parent's signature:
Parent's name:

(Note: Form must be filled completely. Incomplete forms will not be accepted.
Please download & bring the hard copy of this form on standard A4 size paper with color photograph along with the original leaving certificate.
Please do not fold the application form.)