RAGHUBIR SINGH JUNIOR MODERN SCHOOL

HUMAYUN ROAD, NEW DELHI-110003

APPLICATION FOR REGISTRATION
TO
PRE-SCHOOL CLASS
ACADEMIC SESSION 2014 - 2015




(PLEASE FILL IN BLOCK LETTERS)
1. Please indicate the category to which you are applying with a in the relevant box :
Alumni Sibling General

2. Name of the Child _______________________________________ Boy / Girl __________

3. Date of Birth: DD MM YYYY Age as on 31.03.14 ____________
Date of Birth in words _____________________________________________________________
4. Details of Childs Parents: Father Mother
Name __________________________ _______ _____________________________
Residential Address _________________________________ _____________________________
_________________________________ _____________________________
_________________________________ _____________________________
Tele. No. (Residence) _________________________________ _____________________________
(Mobile) ________________________________ _____________________________
E-mail ID: _______________________________________ _____________________________

5. Details of Alumni. (Please put a in the appropriate box):

Mother Father Grandparent(s)


6. Details of Sibling(s) studying at Raghubir Singh Junior Modern School and/or Modern School Barakhamba Road:

Name of the Sibling(s) Class Attending Admission No.
_________________________ ______________ ____________
_________________________ ______________ ____________

P.T.O.

Please read the instructions overleaf.
Certificate from the parent (overleaf) must be signed for acceptance of this form.
Regn. No. ....

Date of Submission .


Please paste the
latest photograph
of the child here.




RAGHUBIR SINGH JUNIOR MODERN SCHOOL
HUMAYUN ROAD, NEW DELHI-110003

GENERAL INSTRUCTIONS

1. Kindly fill in the form in CAPITAL LETTERS only.

2. Please use only a blue / black ball pen to fill the form.
3. Do not enter the registration number yourself.
4. Use appropriate tick mark in the relevant box given in section 1 and 5.

5. Please attach the following documents on the day of submission of form. Incomplete form will not be accepted.
a) Proof of residential address. (Photocopy of any one of the following documents is to be enclosed):

Ration Card issued in the name of parents (mother/father having name of the child) /
Domicile Certificate of child or of his/her parents / Voter ID / MTNL Telephone Bill /
Electricity Bill / Water Bill /UID Card / Passport.
b) In case of sibling applicant, duly signed certificate from the school office.
c) In case of parent / grandparent being alumnus, duly signed certificate from the school office.
d) Self attested photocopy of the Date of Birth Certificate of the child.

6. Kindly note that the school DOES NOT provide transport facility to Pre-School class.



CERTIFICATE FROM THE PARENT

I / We accept the process of admission undertaken by the school and I / we will abide by the decision taken by
the school authorities.

I / We also understand that the application / registration / wait listing does not guarantee admission to my/our ward.

I / We hereby certify that I / we have not applied at Modern School, Vasant Vihar.

I / We hereby certify that the above information provided by me / us is correct.

I / We understand that if the information is found to be incorrect or false now or later, my / our ward will be
automatically debarred from the admission / continuance without any correspondence in this regard.





(Signature of Mother) (Signature of Father)

Name of Mother _______________________________ Name of Father __________________________