FOR OFFICE USE

Registration No.

Adm. File No.

T.C. File No.
Date Of Admission
Student Id. 1428293
Academic Year 2023-2024

To,
The Principal
Podar International School

I DHARMESH / KALPANA KUMAR seek admission for my child in

School Location : Santacruz Curriculum : ICSE. Class : V

STUDENT INFORMATION :

Name : UTKARSH KUMAR

(First) (Middle) (Last)

Date Of Birth : 10/01/2013

Place Of Birth : Mumbai Gender : Male Religion: Indian Hindu

Caste Category : Other

Nationality Indian Adhar Card No. 639275819953

Address for 503, Samruddhi Building,Road No. 22, Sion

Communication :
Sion,Mumbai

Maharashtra,India - 400022

Tel No : Mobile No : 9820183444

Email : dharmesh.kumar@sbi.co.in

EMERGENCY CONTACT :

Name : DHARMESH KUMAR Relationship : Father

Contact number : 9820183444

HEALTH INFORMATION:

Blood Group : A +ve

Height : 144 cms Weight : 25 kgs

Regular Medication :

Regular Medication
with dosage :

Any Impairment :

Exemption from
Activities :

INFORMATION OF PARENTS :

Father Mother

Name in Full : DHARMESH KALPANA KUMAR

Qualification : B.SC M.tech

Company Name : State Bank of India

Designation : Banker Housemaker

Date of Birth : 21/04/2023 19/04/1973

Mother Tongue : Hindi Hindi

Office address : 503, Samruddhi Building,Road No. 22, 503, Samruddhi Building,Road No. 22,
Sion Sion

Sion,Mumbai Sion,Mumbai

Maharashtra,India-400022 Maharashtra,India-400022

Tel No. (Res) : 9004113336

Tel No. (Off) :

Mobile No : 9820183444 9820183444

Email : dharmesh.kumar@sbi.co.in dharmesh.kumar@sbi.co.in

PAST ACADEMIC INFORMATION :

Name of the school attended Location Class Completed Years Attended Language of Instruction Curriculum

Podar International School(ICSE) Nerul 4th 1 English Icse

Documents to be submitted : 1) Xerox copy of Birth Certificate 2) School Leaving Certificate Original
3) Report Card Original 4) Color Passport size Photograph
I shall abide by all the rules and regulations of the school already in existence or those that may be impemented in future.

24-06-2023

Date Signature of the Parent

birth_certificate
Parent_PanCard
AdrProof
Marksheet
SchoolLC
AadhaarCard
PrvReport
StuPhoto