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N. C. JINDAL PUBLIC SCHOOL
Please affix
recent Passport
Size Photograph
here
Punjabi Bagh, New Delhi-110 026
REGISTRATION FORM
ISSUE OF THE REGISTRATION FORM DOES NOT ENSURE ADMISSION
Academic Session 2015-2016
Registration No. .................
(To be filled by Office)
Registration for Class................................
1
Name of the Student (in Block Letters)
2
Date of Birth (Enclose Proof)
Stream ................................................................... (For class XI only)
DD
MM
YY
(In Words)
3
Place of Birth
4
Mother Tongue
5
School last attended
6
Sex
7
Class to which admission is sought
8
Father’s Name (in Block Letters)
Male
Female
i) Designation/ Occupation
ii) Office Address
iii) Residential Address
Pin Code
iv) Tel. No. (Residence)
v) Tel. No. (Office)
vi) Mobile No.
vii) E-mail Address
9
Mother’s Name (in Block Letters)
i) Designation/ Occupation
ii) Office Address (if any)
iii) Residential Address
Pin Code
iv) Tel. No. (Residence)
v) Tel. No. (Office)
vi) Mobile No.
vii) E-mail Address
10
Neighbourhood/Locality *
Code
For office only.
Point
(40)
(Please refer to point no. 30 of the
Prospectus and Footnote.)
11
Yes
Sibling
(30)
Name
If yes, give details
Class
12
No
Section
School Alumni
(Enclose Proof of Class X/XII Pass Certificate
Or
Studied at least for five years evidence)
Admn. No.
Father
Yes
No
Mother
Yes
No
(10 + 10)
13
Girl Child
Yes
No
(5)
14
Single Child / First Child
Yes
No
(5)
(Please enclose affidavit to this effect)
GRAND TOTAL
(100)
Please register my son/daughter/ward named above in your school. I shall produce the required original
documents at the time of admission.
UNDERTAKING
I ............................................................. Father/Mother/Guardian of .....................................................................
hereby declare that information given above by me is based on facts and authentic record. Admission of
my child may be cancelled if any information is found to be false.
Date : ........................................
Signature of Parent/Guardian
(Please enclose the photocopies of supporting documents alongwith the registration form. The originals will be
checked at the time of admission).
*Locality
A
B
C
D
E
F
G
H
40
35
30
25
20
15
10
05
Code
Points
N.C. JINDAL PUBLIC SCHOOL
PUNJABI BAGH, NEW DELHI-110026
RECEIPT
Registration No. .........................
Form No. .........................
Name of the Student......................................................................................................................................
Son/Daughter of Sh. / Smt.............................................................................................................................
Class to which admission is sought.........................
Pre-School
DATE...............................
ADMISSION INCHARGE / SUPDT.