Registration form

DAV MUKHYAMANTRI PUBLIC SCHOOL, KHARMORA, KORBA

(Managed by DAV College Managing Committee, New Delhi ) Affiliated to CBSE vide No - 3330318
Student Application Form for Admission

Fill out the form carefully for registration
Admission No.
For office use only
Student Name*

First NameLast Name
Photo of the Student*

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File must be in .Jpg, .Jpeg, .png format and size must be max. 50 kb. Cancelof
Mother's Name*

First NameLast Name
Father's Name*

First NameLast Name
Class in which admission is sought
Only in LKG to IX and XI
Choice of subjects for class XI ( Science)

HindiPhysical Education
MathematicsBiology
Birth Date*

MonthDayYear
Date of Birth in words-
Age as on 1st April 2020
Years
Months
Days
Gender*
Blood Group
Nationality
Religion*

HinduMuslimSikhChristianJain
Category*

SCSTOBCGENERAL
In case of ST/SC/OBC Cast certificate is to be uploaded only which is produced form competent authority.

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File format must be in form of .jpeg, .jpg, .png only. Cancelof
Present postal address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Permanent address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student E-mail
Mobile Number 1*
Mobile Number 2
Should be Empty:

DAV MUKHYAMANTRI PUBLIC SCHOOL, KHARMORA, KORBA