Admission Form
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Personal Information
     Note:  The details entered in the form must match exactly with the Passport/ Birth Certificate/ Aadhar Card/ Previous School TC. Entries once made will not be changed. Aadhar card & passport details for Parents details in the form.
*Name of the applicant (As in Certificates)
(First Name) (Middle Name) (Last Name)
*Date of Birth:
Fill the DOB in MM/DD/YYYY Format
*Gender Male Female
*Nationality *State of Domicile
*Religion *Caste Category
*Mother Tongue Identification Mark
*Applicant Email Address *Place of Birth
*Confirm Applicant Email *Aadhar Card Yes No
*Passport Yes No
Present Address
*Address Line 1 Mobile No.
Address Line 2 Telephone
*Town/City *District
*Country
*Pincode
*State
Note Either of Mobile No. or Telephone with Area Code is mandatory.
Permanent Address Same as Present Address? Yes No
Permanent Address
*Address Line 1
Mobile No.
Address Line 2 Telephone
*Town/City *District
*Country
*Pincode
*State
Note Either of Mobile No. or Telephone with Area Code is mandatory
Details of Father
*Father Name *Date of Birth
Fill the DOB in MM/DD/YYYY Format
*Nationality *Mobile
*Email Qualification
*Is your father working? Yes No As a parent you can contribute to the school in Academics Sports Culture
IT
*Father's Aadhar Card Yes No
*Father's Passport Yes No
Details of Mother
*Mother Name *Date of Birth
Fill the DOB in MM/DD/YYYY Format
*Nationality *Mobile
*Email Qualification
*Is your mother working? Yes No As a parent you can contribute to the school in Academics Sports Culture
IT
*Mother's Aadhar Card Yes No
*Mother's Passport Yes No
Guardian Details
Guardian Name
Country
Address Line 1 State
Address Line 2 District
Town/City Pincode
Mobile No Relationship with the Applicant
Photo Upload
*Please upload Photographs here(Only .jpg or .jpeg formats, Upto 2000 kb).
Health History
*Height Feet Inches *Weight Kg
*Neighbour/Friend/relative to be called in an emergency (Name) *Blood Group and Type
*Neighbour/Friend/relative to be called in an emergency (Contact Number) *Any Drug Allergy
*Any Food Allergy
Past Medical History
Chickenpox Yes No Measles Yes No
German Measles Yes No Mumps Yes No
Diptheria Yes No Rheumatic Fever Yes No
Hear Disease Yes No Poliomyllitus Yes No
Diabetes Mellitus Yes No Dysentery Yes No
Blood Preasure Yes No Malaria Yes No
Heart Problem Yes No Epilepsy Yes No
Tuberculosis Yes No Whooping Cough Yes No
Ear Condition Yes No Operation Yes No
Asthma Yes No Allergies Yes No
Serious injury Yes No Others Yes No
Typhoid Yes No Appendicitis Yes No
Dengue Yes No Chikungunya Yes No
Has your child had any of the following protective measures?
*BCG Vaccination Yes No *Polio Yes No
*MMR Yes No *Tetanus Yes No
*Hepatitus A & B Yes No *Others Yes No
*Chronic health or physical disabilities that Niraj Public School should know about Yes No *Is your child physically handicapped Yes No
 
*Class into which admission sought
*Please mention name of the school last attended
*Do you have siblings studying in Niraj Public School? Yes No
* Kindly mention the preference for 1st Language Telugu Hindi
Check the activities and organizations which your child has participated for at least one semester
Elected School Office Quiz
Forensics Band
Dramatics SUPW
Debate choir
School Publications Photography
Sports Others
 
Other Details
1. My reason for wanting my child to attend Niraj public School is
2. What are his/her favourite subjects?
3. What does the child do in his/her leisure (spare) time?
4. Areas of stength & weakness of my child and awards and recognitions receicved?
5. Attendance at School. How many days of School has the student missed during the last academic year Minimum Moderate Maximum
6. Has the student been suspended/expelled from any other school? Yes No
7. Have there been any behaviour problems at school or at home? Yes No
8. Has the child had any counselling or psychiatric consultation or testing? Yes No
9. A) Did the child have any emotional or disciplinary problems in the past Yes No
10. B) Does the child have physical or learning disablities Yes No
*11. How did you get the information of Niraj public School?
 
*Payment Procedure
Online Payment
Cash payment at school
Application Enclosures
*Birth Certificate (Original) Yes No
*Transfer Certificate (Original) Yes No
Residential Proof Yes No
Photocopy of Certificate of Proficiency Yes No
Any Other Yes No
Declaration
 


I certify that to my knowledge, all the information provided in this application for admission is correct. And the child for whom the admission is sought is our/my son/daughter/relative and we hereby declare and understand that.

Place: ..........................
Date: .........................

Signature of Parent/Gaurdian



 
    I Agree
 
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