ARWACHIN BHARTI BHAWAN SENIOR SECONDARY SCHOOL Affix VIVEK VIHAR DELHI-110095 TEL.:22141630, 22151630 Student’s Photo REGISTRATION FORM Class____________ S. No. Date……………………… 1. (a) NAME OF PUPIL (in block letters)……………………………………………………………………. Date Month Year (b) DATE OF BIRTH (in figures) (in words)……………………………..………………………………………………………………………………………… (c) RESIDENTIAL ADDRESS……………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………. (d) CORRESPONDENCE ADDRESS……………………………………………………………………………………..…….. ………………………………………………………………………………………………………………………………….……… 2. PARENTS DETAILS: Father Mother Affix Father’s Photo Name Affix Mother’s Photo Profession/Designation Monthly Income Academic qualification Telephone no. Res/Mob Office Address 3. Category: GEN SC ST OBC Physically handicapped Others Please attach certificate from concerned Deptt. Of Government of NCT of Delhi, if you belong to SC/ST, OBC and physically handicapped etc. duly attested by the Gazetted Officer. 4. Religion: Hindu Muslim Sikh Christian Bodh Jain Parsi Others 5. School Alumni: Father Mother Year of Passing 6. No. of brothers & Sisters and position of child amongst them.................................................................... 7. Name & Class with section of brothers/sisters studying in this school........................................................ 8. MODE OF TRANSPORT SCHOOL BUS PRIVATE VEHICLE BICYCLE ONFOOT (If private vehicle then submit documents in duplicate with photo of the driver.) 9. In case both are working who looks after the child at home till the mother or father comes back .......................................................................................................................................................... 10. Was the birth of child: Normal FATHER………………………………………. Premature MOTHER………………………………….. UNDERTAKING I............................................................................................................................................................... Father/mother of.................................................................................................................................... hereby declare that information given by me is based on facts and authentic records. Admission of my child may be cancelled if any information is found to be false. Date............................ Name & Signature of Father/Mother................. NOTES: 1. 3 years for Pre School & 4 years for Pre Primary on 31st March. 2. Parents are requested to submit complete application form along with attested copy of original Date of Birth Certificate issued by M.C.D./Municipal/B.D.O. 3. Residence proof to be attached. 4. Registration does not mean reservation of seat. 5. Incomplete Forms will not be entertained. 6. School conveyance available only on existing routes.