CHINMAYA INTERNATIONAL SCHOOL
P 125,WARANGADE, MAAN, BOISAR 401501
Rev. No. & Date : 28 / 07/2017 Doc. NO. : CVT/MR/12
REGISTRATION FORM
NAME OF THE PUPIL [In Capital Letters]
DATE OF BIRTH
GENDER
ADDRESS FOR CORRESPONDENCE
TEL. No.(s)
PERMANENT ADDRESS*
CLASS
RELIGION
MOTHER TONGUE
LANGUAGE SPOKEN AT HOME
PARENT'S INFORMATION:
FATHER'S NAME*
EDU. QUALIFICATION
OCCUPATION & DESIGNATION
NAME & ADDRESS OF THE ORGANIZATION
TELEPHONE No. (s)
MOBILE No.(s)
E-MAIL ID*
NAME OF THE MOTHER
EDU. QUALIFICATION
OCCUPATION & DESIGNATION
NAME & ADDRESS OF THE ORGANIZATION
TELEPHONE No.(s)
MOBILE No.(s)
E-MAIL ID
TOTAL ANNUAL INCOME (In Rs.)
HOW MUCH TIME DO YOU SPEND WITH YOUR CHILD IN A DAY (In Hrs.)
IS THE STUDENT HANDICAPPED (PHYSICALLY / MENTALLY)
ANY LEARNING DISABILITY (If so, Please give details)
SIBLING : ( Real brother/ sister only)
IF SIBLING IN CHINMAYA VIDYALAYA GIVE DETAILS
.
I / we hereby certify that the above information provided by me / us is correct and I / we understand that if the information is found to be incorrect ward shall be automatically debarred from selection / admission process without any correspondence in this regard. I / we also understand that the application / registration/short listing do not guarantee admission o my ward. I /we accept the process of admission under taken by the school and I / we will abide by the decision taken by the school authorities
Signature of the Mother Signature of the father