"DELHI PUBLIC SCHOOL"
O.P. JINDAL SCHOOL Patratu , Ramgarh, Jharkhand-829143. Reg. No: _________ Registration Form For Pre School Class: _________ (Use Block Letters) ISSUE OF REGISTRATION FORM DOES NOT ENSURE ADMISSION REGISTRATION FEE NOT – REFUNDABLE portion indicates weightage school office only (bracket Last column to be filled by Read Instructions overleaf before Name of the Applicant: ____________________________________ Date of Birth : DD _____ MM _____ YY _________ filling up the form Father’s Name: ___________________________________________ points) Mother’s Name: __________________________________________ 1 1(20) Residential Address: ______________________________________ Locality Code ______________________________________ (Please check ______________________________________ notice board) ______________________________________ ______________________________________ Pin Code: ______________________________________ Contact Phone No: ______________________________________ E-Mail Address: ______________________________________ 2 2(20) Sibling Real brother\sister only : Yes ________ No ________ [Tick the appropriate] If sibling is in the same school, Name ________________________ Give details of sibling class – section _________________________ 3 OPJS Patratu Alumni 3(5+5) [Tick the appropriate] If Yes, year of passing (A) Father Yes ____ ____________ No ____ (B) Mother Yes ____ ____________ No ____ 4 - Nationality of child : _____________________ 5 Educational Qualification: 5(20) Post Graduation Graduation Sr. Secondary Sr. Secondary OR OR School Exam School Exam Professional Equivalent 10+2 OR 10 th OR Degree Equivalent Equivalent (A) Father (B) Mother 6 Gender Boy __________ Girl __________ 6(5) 7 Parent Occupation 7(5) Father ____________ _______ Occupation Code ______________________________________ Designation ______________________________________ Organization ______________________________________ Name ______________________________________ Organization Add. ______________________________________ Mother Occupation Code ______________________________________ Designation ______________________________________ Organization ______________________________________ Name ______________________________________ Organization Add. ______________________________________ 8 Illustrative list of parameters: Single Parent Father ________ Mother ________ (5) Staff Ward Father ________ Mother ________ (5) Children belonging to disadvantaged groups name (5) OBC _______ SC\ST _______ Other _______ Children of transferable government employees __________ (5) OR Children of personnel of Defence and paramilitary __________ Forces 9 Provide Information about child’s medical history if any: - All Immunization _______ Yes _______ No - Specific disease suffered \ prevailing - Operation undergone (if any) - Regular Medicine (if any) Occupation Code Code Occupation ADV Advocate AWS Airways ARC Architect DEF Army\Navy\Air-force - Defence services BNK Bank Emp BUS Business CAC Chartered Accountant DOC Doctor EDU Educationist EMB Embassy Emp FIN Financial Org Emp HTL Hotel CIV Civil Services INT International Organizations NWS Journalist\Air\Print Media MER Merchant Navy OTH Others PVT Private sector emp PUB Public sector emp RWS Railway emp SCT Scientist AGREEMENT I\WE hereby certify that the above information provided by me\us is correct and I\we understand that if the information is found to be incorrect or false, ward shall be automatically debarred from selection\admission process without any correspondence in this regard. I\we also understand the application \ registration \ short listing does not guarantee admission to my ward. I\we accept the process of admission undertaken by the school and I\we will abide by the decision taken by the school authorities. I, the undersigned bind myself and my son \ daughter \ ward to abide by the school rules and regulations in all respect and rules & regulations which may be changed or introduced by the school from time to time. In all matters of dispute the decision of the Principal, Delhi Public School, Ahmedabad will be final and binding on me and my son \ daughter \ ward. In case of gross violation of school rules, I shall withdraw my ward from the school, if the management so desires. If the form is not complete in all respects, the application may be summarily rejected. Signature of the Mother Signature of the Father Name of the mother: Name of the Father: __________________________ __________________________ Date: ______________ Please return this form duly filled in, latest by __________________________. List of Supporting Documents to be Produced by the Parents at the time of submission of the form 1. Date of birth certificate of the child 2. Pass out certificate of father / mother (school, graduation, post graduation etc.) 3. Proof of residence (Electricity bill, telephone bill, rent bill, driving license passport) 4. Proof of Sibling (wherever applicable) 5. Proof of Alumni (wherever applicable) 6. Parents occupation (Proof of occupation) 7. Staff (copy of appointment letter) 8. Disadvantage Section (Certificate issued by statutory authority) 9. Transferable (Copy of appointment letter)