DELHI PUBLIC SCHOOL, VASANT VIHAR NEW DELHI

(Junior School, DPS R. K. Puram)

FOR THE SESSION 2023 - 24

Mother's Photograph Father's Photograph

Child's Recent Photograph

Name of Child:

Admn. No.: Blood group:

PReseNrClass / Sec:
Aadhar Number of child: Gender (BIG):
Date of Birth:

Sibling's Name (if any):

Residential Address:

Landline Number (Residence):

Class/ Sec:

Admn. No.:
Emergency Contact Number:

Bus Stop:-
Bus Route:-

Mother's Name:
Father's Name:

Mother's Mobile No.

Father's Mobile No.:
Mother's Email ID:
Father's Email ID:

Designation:
Designation:
Name of Organisation:
Name of Organisation:
Office Address:
Office Address:

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Office Phone No. :
Office Phone No. :
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 DELHI PUBLIC SCHOOL, VASANT VIHAR NEW DELHI
(Junior School, DPS R, K. Puram)

FOR SESSION 2023 • 24

Dear Parents,
I. Kindly fill the proforma in Block Letters.
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2. Take a printout, paste recent pictures and submit by 9 December 2022. Any
change in residential address must be supported by documentary proof and
should also be intimated via school email-id dpsvasantvihar@gmail.com.
Application for the change of address should be submitted in the school office which
will then be forwarded to the Headmistress, This data will be updated in the school
records and also forwarded to DPS R. K. Puram.

JM
3. No change in data should be made directly at DPS R.K.Puram.

s~ Headmistress
(Class Nursery to II)
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Medical History/ Information:

Any allergy / medical information / medication of the child you would like the school to be
apprised of, kindly mention here.You may write NA if not applicable.

Declaration:
1. I I We certify that the information provided by me / us on this form is true and correct to
the best of my knowledge.
2. I I We authorise the school to send SMS and Email on our Mobile Numbers and Email
Addresses given above in the form. ·

Name of Child
- -------- Class / Section· - - - - - -
Father's Name
---------- Mother's Name----------
Father's Signature
--------- Mother's Signature---------
Date:-
-------