Grade Applied For: Pre - KG LKG UKG Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Application Number: Student's First Name:Last Name: Date of Birth: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Sex: Male Female Caste: Most Backward Class Backward Caste Scheduled Caste Scheduled Tribes Open Category Other Backward Caste Do not wish to specify Blood Group: Place of Birth:Nationality: Mailling Address: City: PinCode: State: Country: Permanent Address: City: PinCode: State: Country: Email Address:Phone Number: Father's Name:Qualification: Occupation:Mobile Number Office Address: Mother's Name:Qualification: Occupation:Mobile Number Office Address: SIBLINGS (Brother / Sister) NameDate of BirthParticulars 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Previous Academic Record Name of SchoolPlaceGradeNumber of Years Student's Passport size Photograph: