KALKA PUBLIC SCHOOL

(A unit of Kalka Group of Institutions)

ALAKNANDA, KALKAJI, NEW DELHI -19
PARTAPUR BY PASS, MEERUT (U.P.)

FORM NO. _ _ _ _ _ _ _

REGISTRATION FORM
ADM I SSIO N TO CLASS ___________________
SESSIO N - 2 0 _ _ _ _ _ _ _ _ _ _ _ _ _ _ -20________
FILL IN BLOCK LETTERS
1.

N AM E O F T H E C HI L D

2.

D A TE O F BI RT H ( I N FI G UR E S)
(I N WO RDS)

3.

AGE

4.

NATIO NALI TY

5.

NAM E OF THE SCHOOL (LAST ATTENDED)

6.

C L A S S I N W HI C H ST U D YI NG

7.

PRESENT RESIDENTIAL ADDRESS

WI TH PHONE NO.

8.

F A TH E R' S N AM E
ACADEM IC QUALIFICATION
OCCUPATION: (PLEASE GIVE DETAILS)
DESIGNATION AND OFFICE ADDRESS
WITH CONTACT NO. ________________________________ ___________________________
BUSINESS/PROFESSIONAL/SELF EMPLOYED ________________________________ _
IF PROFESSIONAL : ADVOCATE/DOCTOR/
ENGI NEER/ CA/M ANAGEM ENT SERVI CE

9.

OR ANY OTHER
MOTHER'S NAM E

ACADEM I C Q UALI FI CATI O N

O CCUP ATI O N / DESI G N ATI O N
O FFICE A DD RE SS WITH CO NT ACT NO

. _______________________________________________________________________________________________________

10. W H E T H E R B E L O N G S T O S C / S T

YES / NO

11. YO U R E XP E CT ATI O NS FO R YO U R CHI LD FRO M TH E S CHO O L :

12. A N Y S P E C I A L A P T I T U D E O R T A L E N T T H A T Y O U P E R C E I V E
IN YOUR CHI LD :

1 3 . AR E A S I N W H I CH YO U CO U L D CO NT RI B UT E TO E N RI C H S C HO O L LI F E I N T E RM S O F
TIM E, SKI LL ETC.
( PLEASE TI CK)
CULTURE

MEDICAL

MEDIA

ACADEM IC [

PROFESSIONAL [

SPORTS

14. WHETHER SCHOOL TR AN S P OR T IS R E QU IRE D FOR TH E CHILD? ______________________

15. N AM E & C L A S S O F R E A L B RO T H E R ( S) / S I S TE R ( S ) , I F A N Y A T P R E S E N T S T U D Y I NG I N K PS .

UNDERTAKING
1. I par ent / gu ardian of ______________ take the undertaking that I will abide by the rules and
regulations of the school as laid down in the school prospectus.
2. In case of sudden sickness or any injury to my ward during school hours, I will not hold school
authorities . responsible in any way. In case of further hospitalisation needed besides firstaid given in the
school,taking to the hospital fortreatmentcould be solely my responsibility.

Address

Signature of parent / Guardian