FORM NO:

Bhavan's Public School, Doha-Qatar

Approved and Licensed by the Ministry of Education 2326

Qatar
Al Zawr Street 90, Area 706, Wakrah, Doha-Qatar,
Ph: 44770770/44771100
2017-2018
FAX:44760312 Email:
Website:
Status
Class II

Signature REGISTRATION FORM FOR ADMISSION

CHILD'S DETAILS
Student's Name: AYSHA MUFARRIHA

Gender: Female Place of Birth: INDIA

Date of Birth: 10-Aug-2010 Age on 29-09-2017: 7 Years,1 Months

Nationality: INDIAN Religion:

Qatar ID: 31035603652 Valid Till: 9-Mar-2019

PREVIOUS SCHOOL'S DETAILS

School Name: GREEN VALLEY NATIONAL SCHOOL Location: Outside Qatar

Last Class Attended: Last Date: Medium:
Board: CBSE Studied Arabic In Previous School: No
ACADEMIC RECORD IN LAST ANNUAL EXAMINATION IN PREVIOUS SCHOOL
S. No. SUBJECT NAME SCORE
1 ENGLISH
2 2nd LANGUAGE
3 MATHEMATICS
4 SCIENCE
5 SOCIAL SCIENCE
% OF ENGLISH, SCIENCE &
6
MATHS
ACHIEVEMENTS IN SPORTS/ ARTS/ MUSIC OR OTHER CO-CURRICULAR AREA

FATHER'S DETAILS
NAME: SAJEED AHAMED
QUALIFICATIONS: BACHELOR OF COMMERCE
UNIVERSITY: MAN GALORE
OCCUPATION: EMPLOYEE
ORGANISATION: AL JABER TRADING CONTRACTING
DESIGNATION: PROCUREMENT MANAGER
Qatar ID: 28335602291 Valid Till: 19-10-2017

ARE YOU STAFF: No JOINING DATE:

ADDRESS: 1120, DOH TEL-O TEL-M 97455774816
MOTHER'S DETAILS
NAME: FAIZEEYA BEGUM GUDDEANGADY
QUALIFICATIONS: PRE-UNIVERSITY
UNIVERSITY:
OCCUPATION: PRE-UNIVERSITY
ORGANISATION:
DESIGNATION: HOUSE WIFE
Qatar ID: 28735624919 Valid Till:

ARE YOU STAFF: No JOINING DATE:

ADDRESS: 1120, DOH TEL-O TEL-M 97455774816

SIBLING DETAILS
SIBLING IN ? No ADMISSION NO: CLASS: N.A.
SIBLING NAME: N.A.
SIBLING'S FATHER'S NAME AS PER SCHOOL RECORD:
N.A.
SIBLING APPLIED
No
FOR:

PERMANENT (HOME COUNTRY) ADDRESS

HOUSE/APPT. No & NAME: BASHIRA MANZIL
AREA
STREET: HIGH SCHOOL ROAD KIRIMANJESHWAR
:
CITY: UDUPI STATE: KARNATAKA
COUNTRY: INDIA PIN: TEL: 8254255356

QATAR ADDRESS
HOUSE/APPT. No & NAME: VILLA
LANDMARK: HILAL STREET: HILAL
AREA: NAJMA LOCATION: DOH
TEL. NO.: 97455774816 EMAIL: SAJ_EXMET@YAHOO.COM
MOBILE: 97455774816
TRANSPORT REQUIREMENTS
SCHOOL TRANSPORT NEEDED? Yes AREA: HILAL

Transport facility would be provided at the discretion of the school. School would extend this facility only to the
areas in which the buses of the school ply. It would be the responsibility of the parents to drop/pickup the child from
the specified bus pickup/ drop point.

KNOWLEDGE OF LANGUAGES
FIRST LANGUAGE (MAIN): HINDI
OTHER LANGUAGES: URDU
PROFICIENCY IN ENGLISH:
READING: EXCELLENT
WRITING: EXCELLENT
SPEAKING: EXCELLENT

DISPLAY OF EXCEPTIONAL TALENT

Has your child ever been selected for specific enrichment activites?
YES
Details:
SCHOOL ACTIVITIES:SPORTS AND DRAMA

Has your child represented the school or country in sports?

NO
Details:

DETAILS PERTAINING TO HEALTH

HEALTH CARD NO./MEDICAL INSURANCE NO.
BLOOD GROUP: A+
Does the child have any allergies?
NO
Details:
Does the child have any disabilities?
NO
Details:
Is the child on any specific medication?
NO
Details:
Does the child have any condition which restricts participation in Physical Education?
NO
Details:
Any other medical condition of the child that the school should be aware of?
NO
Details:
CHILD`S DISCIPLINARY, SOCIAL, PHYSICAL AND PSYCHOLOGICAL DETAILS
Has the child received any sort of learning support or therapy?
NO
Details:
Does the child have any special education needs?
NO
Details:
Does the child require support for English as an Additional Language [EAL]?
NO
Details:
Has the child ever repeated/ failed a grade?
NO
Details:
Has the child's behaviour been a cause of concern in the previous school?
NO
Details:
Any information relate to communication and interaction that the school should be aware of?
NO
Details:
Are there any family circumstances of which you feel the school should be aware of?
()
Who will the child be living with?
Details:

DECLARATION
We hereby declare that all the information supplied above, by us, are true to our knowledge. We are also aware
that submission of this form, by no means, warrants the admission of our child to the school. We are also aware
that at any stage, if any of the above information is found to be incorrect, it would lead to the cacellation of
admission of our child, if granted.

Registration is on a First come first serve basis and is complete only on the payment of Registration
fee at the School fee counter and submission of documents. PLEASE NOTE: REGISTRATION FEE IS
NON REFUNDABLE.

SIGNED: DATE:8-Mar-2017
SAJEED AHAMED FAIZEEYA BEGUM GUDDEANGADY

FATHER'S SIGNATURE MOTHER'S SIGNATURE

 SPACE FOR SCHOOL'S USE

Student's Name: AYSHA MUFARRIHA Submit Date: 8-Mar-2017

Form No: 2326 For: Class II Session:2017-2018
Note:-If you have any difficulty in filling the form please write to .