FORM No.

DELHI PUBLIC SCHOOL, JODHPUR 111602

BY PASS ROAD, PAL, JODHPUR (RAJ.) 2011-2012
TEL: 0291-2766887/888
Class IV
Bitmap Email : info@dpsjodhpur.in Website : www.dpsjodhpur.in

REGISTRATION FORM FOR ADMISSION

CHILD'S DETAILS
STUDENT'S CATEGORY Day Scholar
CHILD'S NAME DHRUV JAIN
PLEASE PASTE A PASSPORT
GENDER Male
SIZE PHOTOGRAPH
DATE OF BIRTH 12/7/2002
NATIONALITY Indian
 
PREVIOUS SCHOOL'S DETAILS
SCHOOL'S NAME ST ANNES PREP SCHOOL LAST CLASS ATTENDED Class III
BOARD CBSE MEDIUM ENGLISH
 
ACADEMIC RECORD OF LAST ANNUAL EXAMINATION IN PREVIOUS SCHOOL
S. No SUBJECT SCORE OUTSTANDING ACHIEVEMENTS
1 ENGLISH 8.3 A GAMES A+
2 HINDI 7.7 B DRAWING A+
3 MATHEMATICS 8.3 A CRAFT A+
4 SCIENCE 9.3A+ DANCE A+
5 SOCIAL SCIENCE 8.5 A
6 COMPUTER 8.0 A
7 GK 8.7 A
 
ACHIEVEMENTS IN SPORTS/ARTS/MUSIC OR OTHER CO-CURRICULAR AREA

FATHER'S DETAILS
FATHER'S NAME PUNIT KUMAR JAIN
QUALIFICATION 12

UNIVERSITY RBSE

OCCUPATION Business

DESIGNATION MD EMAIL sudhirin@gmail.com

ORGANISATION
OFFICE ADDRESS RESIDENTIAL ADDRESS

PHONE No. (O) (R) MOBILE

MOTHER'S DETAILS
MOTHER'S NAME RITU JAIN
QUALIFICATION M.A.

UNIVERSITY SUKHADIA UNIVER.

OCCUPATION HOUSE WIFE

DESIGNATION HOUSE WIFE EMAIL sudhirin@gmail.com

ORGANISATION
OFFICE ADDRESS RESIDENTIAL ADDRESS
SUDHIR KUMAR JAIN 30 SARDAR CLUB SCHEME AIR FORCE JODHPUR(RAJ) 342011

PHONE No. (O) (R) MOBILE

PERMANENT ADDRESS
HOUSE/APPT. No. & NAME 30
STREET Sardar Club Scheme AREA Air Force
CITY JODHPUR STATE Rajasthan
COUNTRY INDIA PIN 342011
PHONE No. (O) 2671925 (R) 2671925 MOBILE 9414127711
 
DETAILS FOR CORRESPONDENCE
MOBILE 9414127711 EMAIL sudhirin@gmail.com
 
ARE YOU A DPS JODHPUR STAFF No JOINING DATE
 
SIBLING DETAILS
SIBLING IN DPS JODHPUR No ADMISSION No.
Class N.A. SIBLING NAME N.A.
SIBLING FATHER'S NAME AS PER SCHOOL RECORD N.A.
 
TRANSPORT REQUIREMENTS
SCHOOL TRANSPORT NEEDED ? Yes
 
INSTRUCTIONS
1. Please submit the following with this registration form :
a) Attested photocopy of Municipal Birth Certificate for classes Nursery, Prep & I.
b) Transfer Certificate in original for Class II onwards on grant of admission.
c) Two recent passport size photographs.
  2.Transport facilities will be provided by the school only on the specified bus routes. It will be the responsibility of the parents /
guardians to drop / collect the ward from the specified bus stop.
3.Kindly note that due to limited number of seats available, it will not be possible to register / admit all children. The application form
made here in no way entitle the candidates to be admitted to the school. Information regarding interaction with the parents will be sent
later.
 
Principal
 
CERTIFICATE
1. I understand that rendering false or misleading information or withholding correct information may disqualify the child from
admission and/or to study in Delhi Public School, Jodhpur.

2. As long as the child does not deposit his/her Birth Certificate and Transfer Certificate, his/her admission will be deemed Provisional.

3. I have made satisfactory arrangement for remittance of school fee within due dates without waiting for a reminder from the school. I
will pay the school fee through crossed Cheques/Demand Draft/cash in favour of the Delhi Public School, Jodhpur as per rules.
 
4. I hereby certify that my ward and myself shall follow all the rules, regulations & procedures laid down by the school from time to
time.
5. I understand that once admitted, the child will not be entitled to refund the fee deposited except the caution money.

6. I fully understand that the school, on accepting the registration of my ward is not in anyway bound to grant admission as this is purely
based on availability of seats. I also understand that the decision of the Principal regarding admission will be final and binding on me.

   

 
PUNIT KUMAR JAIN RITU JAIN