Student Registration Form

Personal Information:

1. Full Name: ___________________________

2. Date of Birth: ____/____/____

3. Gender: [ ] Male [ ] Female [ ] Other

4. Nationality: ___________________________

5. Contact Number: ________________________

6. Email Address: _________________________

Address:

7. Street Address: ________________________

8. City: ________________________

9. State/Province: ________________________

10. ZIP/Postal Code: ________________________

Educational Background:

11. Previous School/College: ________________________

12. Grade/Class: ________________________

13. Year of Passing: ________________________

Emergency Contact:

14. Emergency Contact Name: ________________________

15. Relationship to Student: ________________________

16. Emergency Contact Number: ________________________

Medical Information:

17. Allergies (if any): ________________________

18. Current Medications (if any): ________________________

Parent/Guardian Information:

19. Parent/Guardian Full Name: ________________________

20. Relationship to Student: ________________________

21. Contact Number: ________________________

22. Email Address: ________________________

Additional Information:
 23. How did you hear about our institution? ________________________

24. Any special talents or interests? ________________________

Declaration:
I hereby declare that the information provided above is true and accurate to the
best of my knowledge. I understand that any false information may result in the
rejection of my application.

Signature: ________________________
Date: ____/____/____

Feel free to customize the form based on the specific

needs and requirements of your institution or organization.
Additionally, you might want to include a section for terms and
conditions or any specific policies related to student
registration.

# Student Registration Form

## Personal Information:

1. **Full Name:**

2. **Date of Birth:**

3. **Gender:**
- [ ] Male
- [ ] Female
- [ ] Other

4. **Nationality:**

5. **Contact Number:**

6. **Email Address:**

## Address:

7. **Street Address:**

8. **City:**

9. **State/Province:**

10. **ZIP/Postal Code:**

## Educational Background:
 11. **Previous School/College:**

12. **Grade/Class:**

13. **Year of Passing:**

## Emergency Contact:

14. **Emergency Contact Name:**

15. **Relationship to Student:**

16. **Emergency Contact Number:**

## Medical Information:

17. **Allergies (if any):**

18. **Current Medications (if any):**

## Parent/Guardian Information:

19. **Parent/Guardian Full Name:**

20. **Relationship to Student:**

21. **Contact Number:**

22. **Email Address:**

## Additional Information:

23. **How did you hear about our institution?**

24. **Any special talents or interests?**

## Declaration:

I hereby declare that the information provided above is true and accurate to the
best of my knowledge. I understand that any false information may result in the
rejection of my application.

**Signature:**

**Date:**