t t r tT/Regn. No.

a faeT Ho 3,IÇA-4, Ttarara

KENDRIYA VIDYALAYA No. 3, NH-V, FARIDABAD
H/Session: 20 -20
Photograph of the
o oS. No. 0021 child
(Passport size)
oftrorfay FT/Registration for class

Name of child in full (in Capital letters).

°)*°°******°** **** *******************************. **********************************

fer/Sex FT/Male /Female fi/Third Gender

2. - f a f ( */Date of Birth (in figure) f/Day HTE/Month q/Year

/ln **************** *************" *** °****°***** aT/Year TH Month fe Day

31.03.2075 TgAge as on 31.03.20.
3. T KHE (Rh afa)
Blood Group ofthe child (with Rh factor) Aadhar No. of the child
4.
afem aut/The category whichchildbelong to

Gen. Cat. SC ST OBC EWS BPL Diff. Abled s.G. Child grand childd

Ifthe child belong to SC/ST/OBC/EWSBPL/Disabled/S.G. Category, then, please attach relevant certificate.
5. HTT-fAT T/Details of Mother/ Father HTAT/Mother faT/Father
6) T n i *)/Name (in Capital letters) ****************

Gi) Ta/Nationality *********"*** **********************

(ii) aqA4/Occupation **************e*******

************************************************************************

********************°******* ****************************************************

Name of Office and full address with

telephone numbers *************** ******************************

Full residential address with

telephone numbers (with proof) ***************

(vi)-/EmailID ****************e******* ****°

(vi)yferer gd (t. d)/Distance from KV Ginkm)*. ********************************************** ******

(vii) da/Basic Pay e****************.*****.

(ix) THIaui s rT/No. of Transfers** *****************

x) HraT-fraT t/Category of the Parent# *********************e*************e********************** ********* Y*

Employee Code(if any) *********************************

****

Distance of Residengefrom Vidyalaya.Undertaking from parents is acceptable for distance. Proof of Residence is compulsory.
** 3 1 . 0 3 . 2 0 . . fYET ATT T PITATTRUT FET/No. o f transfers during last 7 years as on 3 1 . 3 . 2 0 . . .

#1. Central govt. 2. arv tAT/Autonomous bodies of Central Govn. 3. TTYyState Govt 4. T TT
Ar4 AT/Autonomous bodies of State Govt. 5. 3/Others

I certify that the above entries are true to the best of my knowledge.
T/frm/xfrarrs TT
Signature of Mother/Father/Guardian
fT/Date:.****** ******** TT TT/Full Name.. . ***********

0021 Tt/ Acknowledgement

Ho/S. No. H/Session: 20 -20 s t r r riAT/Registration No.. **

************

ytoR TA-TT ATT fT

Received an application from ShriVSmt.... .... *****'******* *** ***'** ***********"*********°.... for registration of
ner/ Dis Son dauhter...... . . . . for admission toclass.. * ****

TT/Priacipal
f u r T (zRis) Kendriya V+dyalaya (Stamp)
f/Date. (R.TO)
 AT HTT-A/SERVICE CERTIFICATE
Y ATr/Central Govt)
HTfUa fT TTT&ft/itaat
******

Certified that Shri/Smt.. 1 SWOrking as regular employee in the office/Ministry of

.Govt/Autonomous Body/Public
. He/She is aregular _employee of Defence Service/CRPF/BSFNSG/SPG/CISF/Central
Sector Undertaking fully financed/partially financed by Central Govt. and his/her services are non-
transferable/transferable anywhere in India.

T/Place Signature of Head of the Ofice

fHT/Date (With Name, Designation and Office Stamp)

Complete address and Telephone No. ofoffice_

AT THT-T/SERVICE CERTIFICATE
arHT/State Govt.)
*****************

Certified that Shri/Smt. ..**************************************************snnannnne*seasasnenne**o****enoo*.*. s permanently working in the office/Ministry of

***********'***** *** ** . and his/her services are non-transferable/transferable anywhere in State.

RIT/Place Signature of Head of the Office

fnTa/Date (With Name, Designation and Office Stamp)

Complete address and Telephone No. ofofice

HTATa TT MAT-/CERTIFICATE OF NUMBER OF TRANSFERS
***************************************e********** *******oeoeoo
(AT) ***************************mom

*********momomwwwwwsovenososorewee VTT

I, (Name) .
*********************************e*ssonenanes.*** *********************** . (rank/designation) of .. . (oftice), do
hereby certify that during the past 7 years (up to 31.03.20...I have been transferred .*. **************************** times (in figures & in
words) from one station to another, the details of which are given as under

S.No. Office/Unit
fomi/Date
Place Rank/Designation | /From To Period ofstay Order No.

Iknow that if the above-mentioned facts are found incorect, my child will be disqualified for admission in
Kendriya Vidyalaya.

Signature of Parent

/Note:
Mere Registration will not confer a right to admission.

Incomplete Registration form shall be rejected.

Admission secured on the basis of any wrong certificate shall be cancelled by the Principal.

Please write contact (mobile/telephone) number.