Registration Form
    for the School Year 2009-2010
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Note: If registering, please use this form by printing it, filling in, and
submitting it in person at Shikshantar School, along with Rs 50/- in Cash.
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Class applied for:__________________ Regn.No.___________ Date :___________

Name of the Child:__________________

Date of Birth: __________________

Age, as of April 01, 2009:_____years _______months

Name of the school enrolled in (if any)
____________________________________________ Enrolled since_________________

Permanent Home Address:______________________________________________________
____________________________________________________________________________
Temporary Home Address (if any):_______________________________________________
____________________________________________________________________________
Telephone No.:__________________________Mobile:________________________________
E-mail :___________________________

Mother's / Legal Guardian's particulars Father's / Legal Guardian's particulars

Mother’s name:______________________
Age:_______________________________
Qualifications:_______________________
___________________________________
Last institution attended:
____________________________________
Present occupation:___________________
Organsation Name:____________________
Areas of interest: ____________________
____________________________________
Annual income:
___________________________________
Office Address:
___________________________________
___________________________________
___________________________________
Telephone:
___________________________________
Mobile:
____________________________________
E-Mail:
____________________________________

Father’s name :_______________________
Age:________________________________
Qualifications: ________________________
____________________________________
Last institution attended:
____________________________________
Present occupation:___________________
Organisation Name:____________________
Areas of interest: _____________________
____________________________________
Annual income:
____________________________________
Office Address:
____________________________________
____________________________________
____________________________________
Telephone:
____________________________________
Mobile:
____________________________________
E-Mail:
____________________________________

Have you applied to Shikshantar(for any child) earlier? When and for which class? Please mention child's name in case of you had applied for sibling.___________________________________________________

*Do you live in a nuclear, joint or extended family situation?
(if any other, please specify):________________________________________________

*No. of siblings of the child:___________ Their ages:_____________________________

School, if any:_____________________

*Which other school(s) have you applied to?

*Please briefly write why you would like your child to attend Shikshantar?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

For official use only: