DAV MUKHYAMANTRI PUBLIC SCHOOL, SARBAHARA

DAV MUKHYAMANTRI PUBLIC SCHOOL
SARBAHARA, G.P.M (C.G.)

(Under the direct Management of DAV College Managing Committee, New Delhi) Affiliated to C.B.S.E New Delhi, Vide Affiliation No. : 3320253

APPLICATION FORM
1. Name of Candidate (In Block letters)*
2. Mother's Name*
3. Father's Name*
4. Date of Birth*

DayMonthYear
Date
5. Sex (male / female)*
6. Blood Group
7. Nationality*
8. Religion*
9. Category (ST/SC/OBC/GEN)*
In case of SC/ST/OBC, Cast Certificate is to be produced from competent authority (Strike out which is not applicable)
10. Class in which admission is sought*
11. For admission in class XI, Choice of Stream (Science/Commerce)
12. Subject to be taken
13. Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
14. Contact Number*
15. Details of previous education (Not applicable for admission LKG)
Name of school
Class in which studying
Whether qualified for promotion (yes/no)
Reason for leaving the school
16. Occupation of Father / Mother
Name of Father / Mother
Designation
Department
Place of working
17. a) Name of guardian (if any)
17. b) Profession
18. Name of person with relation
Who will drop / collect child from school
Should be Empty: