“My Profile”

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Father’s Student’s Mother’s

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1. a. Full name of the student:_______________________________________________________

b. Class:_________ Sec:__________
2. Date of Birth: __________________________________ Sex: Male ( )/Female ( )
3. Residential Address:_______________________________________________________________________
_______________________________________________________________________________________
Land Phone:________________________ Mobile: 1.____________________________________________
2.____________________________________________
.
Name Educational Occupation Annual Income
Qualification
Father’s
Mother’s

4. Religion :__________________________________ Caste:___________________

5. a. Joined K.E.CARMEL SCHOOL, in ___________________ (Year), Class________________

b. Distance travelled from home__________________kms. Mode of Transport ______________________
6. Last school attended if any before joining K.E.Carmel School,
Name :_______________________________ Board :_______________________ No. Of Years_________
7. My Family:- Give tick ( ) marks.
a. Type of family the student hails from: Nuclear ( ) / Joint ( ) , No. of members: _____, Brother/s___,
Sister/s___
b. Areas of interest of parents:_____________________________________________________________
The parents are ready to cooperate with the school if situation so arises: Yes( )/ No( )
c. If the student has Brothers / Sisters, fill in the following

Sl. Name Age Relation School Class/Qualification

No.
1
2
3
4
d. Brother or sister is working : Yes( )/ No( ) Details: ____________________________________________
8. a. Name of the local guardian if any:__________________________________________________________
b. Quality time spent by the parents with the student: ___________________________hours per day
9. ACADEMICS:
Student’s strong
Subjects
Student’s Weak
Subjects
a. The student goes for tuition/s : Yes ( )/No.( ) If yes mention subjects: 1.________, 2._______,3._________
b. Time spent for tuition__________ hrs/ week. Total tuition fee per month Rs._________________________
c. Distance travelled for tuition_______ kms/ daily.
d. No. of hrs student studies on his/her own________ daily.
10. COCURRICULAR:- a) Areas of interest and hobby_____________________________________________
b) Special tuitions in co curricular activities: 1)_______________ 2)______________3)_______________
11. AMENITIES AVAILABLE AT HOME:
a) T.V ( ) b) Telephone ( ) c) Computer ( ) d) Internet ( )
12. Time spent for watching T.V : ____________________ hrs daily. Playing games :____________hrs daily
14. BEHAVIOURAL APPROACH: Give tick ( ) marks.
a) The child is quiet ( ) / playful ( ) at home.
b) The child mixes well with others ( ) / does not mix with others. ( )
c) The child enjoys games ( ) / music ( ) / watching cartoon ( )/ playing with brothers and sisters ( )/ going
out with parents ( )/ being alone ( ).
d) The child gets irritated easily: Yes ( ) / No ( ). e) The child is stubborn : Yes ( ) / No ( ).
f) The child is inquisitive : Yes ( ) / No ( ).
g) Independent work habit : Nil ( ) / Average ( ) / Good ( ).
15. SPECIAL ATTENTION AREAS: a) Height: _______cms. b) Weight: ______ kgs c) Blood Group:_____
d) Identification Mark:__________________________. e) Child having spectacles Yes ( ) / No ( )
f) Vaccination Updated: Yes ( )/ No ( )
g) Food habit: Takes healthy food ( ) / Attracted towards fast food ( ).
h) The child has suffered from any major illness: Yes( )/ No( ). If yes, when_______________.
Details:______________________________________________________________________________
i) The child has under gone any major surgery or had any major accident: Yes ( )/ No( ).
If yes, when__________. Details: _________________________________________________________
j) The child is undergoing any treatment at present? Yes ( )/ No( ).
If yes give details: _____________________________________________________________________
k) The child is allergic to any medicine: Yes ( ) / No ( ) Details:__________________________________
16. IN CASE OF EMERGENCY TO CONTACT:
a) Name of the person (in block): ____________________________________________________________
b) Relation with the student: _________________ Land Ph No.: __________________, Mob: ___________

Signature of the Mother Signature of the Father

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