Amity International Schools Admission Form

4/1/12 3:18 PM

Amity International School, Vasundhara(Gzb.), Sector-1

Registration Form Admission sought in : VIII for 2012 - 2013 Regn. No. : 1721807 Password : 6B846E (Page 1)

Last Name of child : Bhatt Child (Applicant)

First Name of the Child : Shantanu Mother Father Siblings in Amity

Date of birth
10/07/2000

Nationality
Indian

Gender
M

Category
GEN

Child with special needs

No

Specification

Percentage

Authentic Certificate

Complete Residential Address

SRA-132-D SHIPRA REVIRA,INDIRAPURAM GHAZIABAD- 201014 Uttar Pradesh

Tel. No : 6491000

Mobile : 9899991502

e-mail : VINOD@WADDAYA.COM
None

Is there any medical information about your ward which the school should be aware of: Name of previous school (pre -School )/Nursery /Cre'Che if any

: BPS PILANI

Period of stay in the previous school; From : 01 Apr 2011 To 23 Mar 2012 Are you a single parent ? No Whether School Transport required? Yes Is your residence on school transport route ?No

http://www.amity.edu/aisadmission/RegistrationPrintLetter.aspx?sRegNo=1D2A87DF-1A50-4A

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Amity International Schools Admission Form

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(Page 2)

Family Information Particulars of Mother

Full Name : KUSUM BHATT Educational Qualifications Education
Xth XIIth BA MSC

Nationality Board / University

UP BOARD UP BOARD KURUKSHETRA UNIVERSITY

Indian 15 Feb 1976 No Business WADDAYA SOLUTIONS PVT LTD DIRECTOR 09 Sep 2009 SRA-132-D SHIPRA REVIRA, INDIRAPURUM GHAZIABAD Uttar Pradesh, India 6491000 9811991502 KK@WADDAYA.COM

Institution attended
GIC RISHIKESH GIC RISHIKESH RISHIKESH KARNAL

Year
1991 1996

Date of birth Is the job Transferable Occupation Organisation working for Designation Date Of Joining Office Address

GARHWAL UVIVERSITY 1999 2004

Whether an Alumni of the school ? No Tel. No Mobile No Email

Particulars of Father
Full Name : VINOD BHATT Educational Qualifications Education
Xth XIIth BSC

Nationality Board / University

UP BOARD UP BOARD GARHWAL UNIVERSITY

Indian 05 Feb 1967 No Business WADDAYA SOLUTIONS PVT LTD DIRECTOR 09 Sep 2009 SRA-132-D, SHIPRA REVIRA INDIRAPURAM,GHAZIABAD GHAZIABAD Uttar Pradesh, India 6491000 9899991502 VINOD@WADDAYA.COM

Institution attended
GIC NAUGON KHAL GIC NAUGON KHAL DEHRADUN

Date of birth Year

1986 1988 1991

Is the job Transferable Occupation Organisation working for Designation Date Of Joining Office Address

Whether an Alumni of the school ? No Tel. No Mobile No Email

http://www.amity.edu/aisadmission/RegistrationPrintLetter.aspx?sRegNo=1D2A87DF-1A50-4A

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Amity International Schools Admission Form

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Particulars of Guardian
Full Name : VINOD BHATT Educational Qualifications Education
Xth XIIth

Relation to candidate Board / University Year Nationality Date of birth Occupation Organisation working for Designation Date Of Joining Office Address

FATHER Indian -

Institution attended

, ,

Tel. No Mobile No Email Signatures:

I hereby certify that the information given in the Registration form is complete and accurate. I Understand and agree that misrepresentation or omission of facts will justify the denial of admission, the cancellation of admission, or expulsion.

---------------------------------------------------Signature of Father / Guardian Date :

---------------------------------------------------Signature of Mother / Guardian Date :

Note : On the day of submission of form you have to bring the printout of the Registration form with photographs and self attested copy of child's date of birth certificate and copy of residence proof.

Amity International School, Vasundhara(Gzb.), Sector-1

Registration Slip Regn. no : 1721807 Password : 6B846E Class : VIII Session : 2012 - 2013 Child Name : Shantanu Bhatt Date for submission of form : Time : Venue : Sl.No. :
Photograph of the Child

http://www.amity.edu/aisadmission/RegistrationPrintLetter.aspx?sRegNo=1D2A87DF-1A50-4A

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Amity International Schools Admission Form

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Transaction No & Date : 201204014737132 Dt 01 Apr 2012

Date .........................................Signature..............................................................

http://www.amity.edu/aisadmission/RegistrationPrintLetter.aspx?sRegNo=1D2A87DF-1A50-4A

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Amity International Schools Admission Form

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http://www.amity.edu/aisadmission/RegistrationPrintLetter.aspx?sRegNo=1D2A87DF-1A50-4A

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