PERFORMA FOR CBSE REGISTRATION OF CLASS XI Students for session 2022-23

Fill in capital letters (as per school record)

1. NAME OF STUDENT : _____________________________________
2. M/F : ______________ 3. CAT ( GEN/OBC/ST/SC): __________
4. CLASS : ___________ 5. ADM. NO : ______ 6. DATE OF ADM. _____________
7. MINORITY ( Y/N) : _____________ 8. PWD( Y/N) : ______________
9. F’ NAME : _____________________________
10. M’NAME : ____________________________
12. DATE OF BIRTH (DD/MM/YEAR ) : ______________
13. ONLY CHILD (Y/N) : ___________
14. MOBILE NO :__________________________
15. EMAIL ID : ________________________________
16. AADHAAR NO : __________________________ ( Attach photocopy)
OR ANY OTHER GOVT. VALID IDENTITY NO : _____________________
17. ANNUAL INCOME OF FAMILY : ______________________________
18. DETAILS OF X EXAM PASSED ( ATTACH CLASS X MARKSHEET) :
ROLLNO/YEAR/CLASS/BOARD
____________________________________________________
19. Main Subjects in CLASS XI ( with subject code ) :
a)
b)
c)
d)
e)
1
Additional/skill subject ( if any) :
f)

FATHER SIGN: MOTHER SIGN C.TEACHER :

DATE:

 All names should be verified from class X certificate.

 Photograph of child ( soft copy less than 40kb) passport size/ black & white/School
dress with name of child & date on photograph to be submitted to class teacher.
 In case of PWD ( Persons with Disabilities) / SC/ST/OBC attach Govt. Certificate.
 Submit Rs 300/= as cbse registration fees to the class teacher.