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                                                       Student’s Admission FORM

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Name of the School :  KALABONI PRIMARY SCHOOL

U-DISE Code :  19230905401

                                             A. Basic Information:

1. Name :                                                      

2. DOB * :                                                        3. Birth Regn. No:

4. Gender* :

5. Social Category*:                                                            6. Religion :

7. Mother Tongue*:                                                            8. Nationality* :

9. Aadhaar No. :

 

10. Blood Group :                                                                 11. Health ID :

12. Identification Mark: _________________________________________________________________________________

 

                                B. STUDENT’S Contact Information:

1. Address : __________________________________________________________________________________

2. Habitation or Locality* : __________________________________________________________________________________

3. District* : __________________________________________________________________________________

4. Block/Municipality* : __________________________________________________________________________________

5. Panchayat : __________________________________________________________________________________

6. Post Office* : __________________________________________________________________________________

7. Police Station* : __________________________________________________________________________________

8. Pin Code* :

9. Contact No. :

10. Email : __________________________________________________________________________________

                                                   C. Guardian’s Details:

1. Father's Name : ______________________________________________________________________________

2. Mother's Name : ______________________________________________________________________________

3. Guardian's Name* : ______________________________________________________________________________

4. Relationship(with Guardian)*:_________________________________________________________________

5. Annual Family Income : ______________________________________________________________________________

6. Guardian's Qualification : ______________________________________________________________________________

                                        D. Guardian’s Contact Information:

1. Address : __________________________________________________________________________________

2. Habitation or Locality* : __________________________________________________________________________________

3. District* : __________________________________________________________________________________

4. Block/Municipality* : __________________________________________________________________________________

5. Panchayat : __________________________________________________________________________________

6. Post Office* : __________________________________________________________________________________

7. Police Station* : __________________________________________________________________________________

8. Pin Code* :

9. Contact No. :

10. Email : __________________________________________________________________________________

 

                                                 F. Other Information:

1. BPL Status :                                                                     If Yes, 2. BPL No. :

 

3. Children with special need:                                        If Yes, 4. Type of Disability:

 

                                               G. Bank Details: (if applicable)

1. Bank Name : _______________________________________________________________

 

2. Branch Code :

 

3. IFSC :

 

4. Account Number :

 

 

 

                                (PLEASE ENTER THE DETAILS IN BLOCK LETTERS)

 

 

DATE -                                                                                                                                         Guardian’s Signature