

MALDIHA GANESHPUR P.M.S PRIMARY SCHOOL PASTE RECENT
PHOTO
ADMISSION FORM
A.BASIC INFORMATION:
NAME....................................................................................................................................................................
D.O.B..................................................................... BIRTH CERTIFICATE NO......................................................
GENDER: MALE/FEMALE/TRANSGENDER (please tick)
RELIGION.............................................. NATIONALITY......................................................................
AADHAR NO.................................................................. BLOOD GROUP............................................................
IDENTIFICATION MARK...........................................................................................................................................
B.CONTACT INFORMATION:
ADDRESS..............................................................................................................................................................
P.O............................................................... PANCHAYET...................................................................................
P.S.............................................................. BLOCK/MUNICIPALITY....................................................................
PIN............................................................... DIST..............................................................................................
CONTACT NO................................................................... MAIL.ID......................................................................
C.GUARDIAN'S DETAILS:
FATHER'S NAME........................................................................... MOTHER'S NAME.............................................
GUARDIAN'S NAME...................................................................... RELATION WITH GUARDIAN'S.............................................
MAIL.ID......................................................................... CONTACT NO..........................................................................
D.GUARDIAN'S CONTACT INFORMATION.
ADDRESS........................................................................................................................................................................
P.O......................................................................... PANCHAYET.........................................................................................
P.S........................................................................ BLOCK/MUNICIPALITY.........................................................................
PIN.......................................................................... DIST.........................................................................................................
CONTACT NO......................................................................... MAIL ID......................................................................................
E.OTHER INFORMATION.
1.BPL STATUS......................................, if yes 2.BPL NO....................................,,,,,,,,,,,,,,,,,
3.CHILDREN WITH SPECIAL NEEED..........................,if yes 4.TYPE OF DISABILITY...................................................................
5.DISADVANTAGE GROUP..............................................................................................................
F.BANK DETAILS.
BANK NAME..............................................................................................
BRANCH CODE.........................................................................................
IFSC..........................................................................................................
ACCOUNT NUMBER....................................................................................
SIGNATURE OF GUARDIAN'S/FATHER.S/MOTHER'S...........................................................................
SIGNATURE OF HOI.......................................................................