Amity Admission Pushp Vihar
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Transcript of Amity Admission Pushp Vihar
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REGISTRATION FORM
s there any medical information about your ward which the school should be aware of:
CONTACT INFORMATION :
Telephone : Mobile :
E-mail :
Address
City : Pin : State :
Is your child attending any playgroup / preschool / cre'che / daycare :
Dates of attendance : From : To :
DD MM YYYY DD MM YYYY
1
SI. No. Admn. No. Name Class School
1.
2.
3.
SIBLINGS IN AMITY / AMIOWN
TRANSPORTATION
Is school Transportation Required ? ("Yes" does not confirm school transportation)
If yes, Is your residence on school transport route ?
If no, Are you in a position to provide safe transportation to your child?
YES NO
YES NO
YES NO
Regn. No. :
Password :
First Name
NFORMATION ON CHILDLast Name
Category
Gen SC S
NationalityDate of Birth
DD MM YYYY
Gender
Male Female
Please affix a recentcolour photograph
Mother
Please affix a recent
colour photograph
Father
Please affix a recent
colour photograph
Child (Applicant)
Amiown,Pushp Vihar2121310
E79918
TOKAS LAKSHYA
15 10 2008 Indian
None
62A/2 LAXMI MARKET
MUNIRKA
NEW DELHI 110067 Delhi
01126188057 9818206603
MOTHER'S PRIDE
18 09 2011 31 03 2012
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Regn. No.:
2FAMILY INFORMATION : Are you a single parent YES NO
Organisation working forOccupation
Designation Date of Joining
DD MM YYYY
Annual Income
Level Education School / Institute Board / University Passout Ye
X
XII
Graduate
PG
Doctorate
Others
Educational Qualifications
Date of Birth
DD MM YYYY
NationalityParticulars of MotherName
Passout Year
Whether an Amity Alumni
Institute / School
YES NO
Organisation working forOccupation
Designation Date of Joining
DD MM YYYY
Annual Income
Level Education School / Institute Board / University Passout Ye
X
XII
Graduate
PG
Doctorate
Others
Educational Qualifications
Date of Birth
DD MM YYYY
Nationality
Particulars of Father
Name
Passout Year
Whether an Amity Alumni
Institute / School
YES NO
Telephone : Mobile :
E-mail :
Office Address
State : Country :
City : Pin :
Telephone : Mobile :
E-mail :
Office Address
State : Country :
City : Pin :
2121310
NAVEEN TOKAS 08 10 1983 Indian
Business PROPERTY/ESTATE
OWNER 400000
50 A, MUNIRKA VILLAGE
NEW DELHI
Delhi India
01126188057 9818206603
Xth NIOS CBSE 2001
XIIth NIOS CBSE 2003
KAVITA TOKAS 05 05 1981 Indian
Home Maker NA
NA
NEW DELHI
Delhi India
26188057 9818137468
Xth CBSE 1998
XIIth CBSE 2000
MD UNIVERSITY 2004
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Regn. No.:
Note / Reminders:
1. Please ensure that your form is complete with all the documents mentioned below (in point no.5) at the timesubmission on the date of interaction. Incomplete forms will not be processed.
2. Please keep photocopy of the completed application form with you.
3. Please affix recent coloured photographs.
4. School fees once paid is non refundable and non negotiable.
5. List of doucments to be enclosed with the registration form,
a. Original and Photocopy (attested) of Birth Certificate
b. Residence Proof
c. Educational Qualification Certificates of both Parents.
We hereby certify that the information given in this Registration form is complete and accurate. We understand and agree that
misrepresentation or omission of facts in this form and the enclosed documents will justify the denial of admission, the cancellation o
admission, or expulsion of our ward.
Signature of Father
Date :
Signature of Mother
Date :
SIGNATURES :
Space
for
Photograph
(Passport Size)
Registration Slip
Regn. no : Password : Class : Session :
Child Name :
Interaction Date : Time : SI. No.:
Transaction No. & Date :
Date of Receipt ............................................. Receiver Signature .............................................
Photograph of the Child
3
(Please paste your business Card)
Father
(Please paste your business Card)
Mother
2121310
Amiown,Pushp Vihar
2121310 E79918
LAKSHYA TOKAS
Nursery 2012 - 2013
will be informed - ---
201201129139693 Dt. 12 Jan 2012
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Regn. No. : Session : Class :
4
First NameNAME OF CHILDLast Name
What are your reasons for choosing Amiown ?
ONLY FOR OFFICE USE:
Document Check List
Birth Certificate.
Residence Proof.
Educational Qualification Certificates of both parents.
Remarks :
Documents Verified by :
Please affix a recent
colour photograph
Mother
Please affix a recentcolour photograph
Father
Please affix a recent
colour photograph
Child (Applicant)
ONLY FOR OFFICE USE:
Signature :
1 2 3
Amiown,Pushp Vihar
2121310 Nursery2012 - 2013
TOKAS LAKSHYA
