Basic Information | |||
Name* | DOB*(DD/MM/YYYY) | ||
Birth Registration Number | Gender* | ||
Social Catagory* | Religion* | ||
Mother Tongue* | Nationality* | ||
Aadhaar Number | Blood Group | ||
Identification Mark | |||
Educational Information | |||
Academic Year* | Admission No* | ||
Admission Date* | Present Class* | ||
Present Section* | Present Stream | ||
Present Roll No* | Previous Class* | ||
Previous Section* | Previous Stream | ||
Previous Roll No | Medium* | ||
If studying in class 1, Status of the previous year | No. of days child attended School (in the prev. year) | ||
Contact Information For Student | |||
Country* | State* | ||
Address* | Habitation or Locality* | ||
District* | Block* | ||
Panchayat* | Post Office* | ||
Police Station* | Pin Code* | ||
Contact No | |||
Guardian Information | |||
Father's Name | Mother's Name | ||
Guardian's Name | Relationship | ||
Annual Family Income | Guardian's Qualification | ||
Guardian's Contact Information | |||
Country* | State* | ||
Address* | Habitation or Locality* | ||
District* | Block* | ||
Panchayat* | Post Office* | ||
Police Station* | Pin Code* | ||
Contact No | |||
Other Information | |||
BPL Status | BPL No. | ||
Children with special need | Disability type | ||
Health ID | |||
Facilities | |||
Disadvantaged Group | Getting free education as per RTE Act | ||
Whether the child is Homeless | No of Uniform Sets Received | ||
Complete set of free books | Free Transport facilities | ||
Free Shoe | Free Exercise book | ||
Free Escort Facility | Free Hostel facility | ||
Special Training Facility | Free Bicycle | ||
Bank Details | |||
Bank Name* | IFSC* | ||
Branch Name* | Account Number* | ||
Signature of Guardian | HOI Signature & Date with Office Seal |