300/-
Phone NO:08952 282405(O)
SMT. GODAVARIDEVISARA HIGH SCHOOL,SHREERAMNAGAR
(Affiliated to CBSE., New Delhi No:130097) Garividi- 535 101, Vizianagaram (Dt)
REGISTRATION FORM- 2018-19
APPLICATION FOR REGISTRATION IN TO CLASS______________________________________
01. Name of the pupil : ______________________________________
(In full & Block Letters)
02. Date of Birth : _________________________________________
(To be supported by a copy of date of
Birth certificate issued by competent authority)
03. Aadhar No. of the candidate: _________________________________________
04. Father’s Name : __________________________________________
Occupation/Designation(if any)
ADDRESS : __________________________________________
__________________________________________
__________________________________________
Phone NO. : ___________________________________________
05 .Mother Name : ___________________________________________
Occupation/Designation(if any) ___________________________________________
06.Particulars of previous Study ____________________________________________
( Applicable for U.K.G..on wards)
A) Class : __________________________________________
B) Name of the school and place: __________________________________________
(Study certificate is to be produced __________________________________________
Date:
Place: Signature of the Parent/ Guardian
REGISTRATION NO: Date of Admission Test:
Office Asst. PRINCIPAL
ACKNOWLEDGEMENT
REGISTRATION NO: Date of Admission Test:
NAME:
CLASS: PRINCIPAL
SMT. GODAVARIDEVI SARAF HIGH SCHOOL, SHREERAMNAGAR
Affiliated to CBSE, New Delhi, No. 130097
APPLICATION FOR ADMISSION-2018-19
Candidate
Recent
Passport
Size Photo
1. Name of the Pupil(In full & block letter) : _______________________________________________
2. Boy or Girl : _______________________________________________
3. Date of Birth (In Words & Figures) : _______________________________________________
(Original Certificate from a Competent
Authority is to be enclosed
4. Religion : ________________________________________________
(This information is intended for
statistically purpose)
5. Caste : ________________________________________________
(If SC/ST/BC/ Certificate issued by
Competent authority)
6. Name of the Father (In block letters) : ________________________________________________
7. Name of the Mother(In block letters) : ________________________________________________
8. Occupation & Annual Income : ________________________________________________
(Of both Parents)
9. Present Address : ________________________________________________
________________________________________________
_______________________________________________
Phone No. (If any) : _______________________________________________
10. Permanent Address _______________________________________________
_______________________________________________
________________________________________________
Phone No. (If any) : ________________________________________________
11. Aadhar No. of the candidate : ________________________________________________
12. Educational qualifications
(a) Father : _______________________________________________
(b) Mother : _______________________________________________
13. Name of the Guardian : ______________________________________________
14. applicable, if both parents are not alive)
(a) Occupation : _______________________________________________
(b) Full address : _______________________________________________
_______________________________________________
_______________________________________________
Phone No. (If any) : _______________________________________________
15. Class last studied and address : _______________________________________________
Of the school last attended
_______________________________________________
16. Whether transfer certificate : _______________________________________________
Is attached or not
17. Class into which admission is sought: _______________________________________________
18. Mother tongue of pupil : _______________________________________________
I declare that the particulars given above is correct and I will abide by the rules of the
School in force from time to time.
__________________________________
SIGNATURE OF PARENT/GUARDIAN
(Guardian is applicable if both parents are not alive)
-------------------------------------------------------------------------------------------------------------------------------------
FOR OFFICE USE
Admission in class: ______________ Admission No: _____________ Date: ________________
Admission fee Rs. _____________paid vide Chillan No: ______________ Dt. ______________
Checked by, PRINCIPAL
