Please read Rules and Regulations before fling up the Registration Form. ISSUE OF REGISTRATION FORM DOES NOT ENSURE ADMISSION, USE ONLY CAPITAL LETTERS 1 Please do not lave any column blank / Use N.A. wherever necessary Name ast MIDDLE AST Dae oraich T]CLILL EL] — Avessonaueanore( 1] (7 CL] sx mL Dite of Birth (i words) dy of — Admission sought in Class Class (in words) ‘The Class child presently studying in Medium of instruction “The School child presen studying in Second Language [eine Jsansleie Dipsite( Including Ex-DPS) Lives = [No Nasional Mother Tongue Does the child suffer from any medicaliphysial problem? Lives [No Special skill and interests SE need ee Subject Enel eet “Second Language Hina Santee Homers Mathers ‘General SceneslEVS Soci Science Aare Interview | Interaction desailsDethi Public School Ww Wavecity, Ghaziabad ct Wee ake uk et aes) SLNo. Parsiculrs of Father Particulars of Mother 1 Name Gr mLock LETTERS) 2. Educational Qualification 3 Occupation 4 Profession/Designation or Bence nature of Business 5S. Office Address 6 Phone Number(s) (Office) 7 Annual Income () '@ Mobile Number(s) 9 Exmall Address 10 Specimen Signature IT Residential Address 12_Phone Number(s) (Residence) (Guardian Name: Relationship with the eandidace; Residential Address: Pin: Mobile Number: ‘Age | Gender | Class E-mail: Schoal Parents Signature