SAGAR PUBLIC SCHOOL

Saket Nagar, Bhopal Ph: 0755-2489601-04

e-mail: spsbhopal@gmail.com

REGISTRATION FORM Form No. : Academic Session: Admission in Class: Students Name (IN BLOCK LETTERS) First Name Middle Name Surname Date of Birth: ( In figures ) D M Y

( In words )_______________________________________________________________________

Place of Birth: City ________________ Gender of the Child : MALE / FEMALE

Nationality __________ Religion ____________Mother Tongue ________Category G SC ST OBC

Local Residential Address_______________________________________________________________________

_____________________________________________________________________________________________

Name of the last School attended ____________________________________________City _________________

Attended From _________________ To _____________________ Reason for leaving ________________________

Last class attended ____________________ Result ________________________ Percentage obtained __________

Area of Interest: Art/ Craft Music Sports Any Other ___________________

Allergy / Any serious ailment ( if any) :______________________________________________________________

Fathers/Guardians name:

First Name Middle Name Surname

Educational Qualification: __________________________________________________ Age __________________

Fathers Occupation & Designation _______________________________ E-mail Address _____________________

Telephone No.(Office) _________________ (Residence) ______________________ Mobile No.________________

Mothers Name :

First Name Middle Name Surname

Educational Qualification: ___________________________________________________ Age _________________

Mothers Occupation & Designation __________________________________ E-mail Address _________________

Telephone No.(Office) _____________________ (Residence) ______________________ Mobile No.____________

Annual income of Parent(s) _____________________________________________________________________

Affix a

recent coloured Photograph

of the candidate

(Submit valid

Caste certificate)

Permanent Address ___________________________________________________________________________

_____________________________________________________________________________________________

Parents contribution: I will be delighted to help the school in the following field:

Field of interest : Academics/ Communication Skill / Personality Development / Sports / Music / Dance / Magazine/ Art

& Craft / Dramatics / Horticulture / ________________________________________________________________

Any Brother / Sister studying/applying for admission (If yes) Name ___________________________ Class _____

If NO: Name_________________________________ class _____ school__________________________________

School bus facility required : Yes No

We certify that the information furnished in the form is true to the best of our knowledge. We hereby agree to abide by

the rules and regulations of the school.

Date :

Mothers Signature Fathers/Guardians Signature

FOR OFFICE USE ONLY

Reg. No_________ Date of Interview / Test ________ Time _______ Result _____ Marks ______

Admitted in Class _______________ on date ____________ Scholar No. ___________________

Submitted Transfer Certificate/Birth Certificate Yes No

Submitted Photocopy of Mark sheet of previous class Yes No

Approved and admission granted by : __________________________

Readmitted in class _________________ on _______________ Scholar No._________________

Recommended by _______________________ Provisional / Undertaking ___________________

Prepared / checked by Principal / Headmistress

FEE DEPOSIT DETAILS

Deposited Admission fee & Caution money Rs. _______________________

By Cash / Cheque No. _________________ Date _____________________

Accountant Administrative Officer

HAVE YOU ATTACHED? Remarks

Attested photocopy of birth certificate with name issued from municipal corporation ( For Nursery Class I )

Two recent passport size photographs of the child

Original Transfer Certificate, counter signed by the competent educational authority ( Class II onward)

Attested copy of Mark Sheet of previous class (Class I onward)

Attested copy of Caste certificate. ( If applicable)

I hereby agree that admission will be treated as provisional till all the required documents have been submitted.

Signature of Parents