Student Personal Detail Form

Fill up this form properly & Clearly

USE BLOCK LETTERS.

Student's Name: _______________________________________________________

Permanent Address: ______________________________________________________

Temporary Address: ______________________________________________________

Date of Birth: ______________________ B.S.

Sex: Male Female

Religion ______________________________ Age: ___________

Cast Dalit Janajati Aaryan Other

Father's Name: _______________________________________________________

Occupation: ____________________________ Contact No.: ___________________

Mother's Name: _________________________________________________________

Occupation: ____________________________ Contact No.: ___________________

Emergency Contact Name/ No.: _____________________________________________

(Other than mentioned above)

Does your child have birth certificate: Yes No

Scholarship: Handicapped Poor Dalit

Martyr's Children other

_______________
Parent's Signature
Note: if the form is lost, sum of Rs. 10/- is charged for another form. Thankyou