For Office Use Only:
App. No. .......... Reg. No. ............
Date ..............
Maharajganj, Ghazipur (U. P.)
Phone: +91 9721452881
Web:, email:
1.   Candidate's Image * :
  Candidate's Name * :
A. Date Of Birth *:
B. Name & address of the school in which now studying:
Board: Medium: Class In which now studying:
(Please attach the photocopy of the mark sheet of the last examination attended and annual result of the previous class duly attested by the head of the institution or a gazetted officer)
C. Admission sought in Class *: Gender *:
  Nationality: Religion : Blood Group:
  Aadhaar No.: (Please attach the photocopy of Aadhaar Card)
  Caste : In case OBC specify tribe: Mother Tongue:
D. Special aptitude and interest:
E. Allergic to (If any):
(Medical fitness certificate by any qualified medical practitioner not less than MBBS to be provided)
2.   Father's Name:
    Qualification: Occupation: Contact No.:
3.   Mother's Name:
    Qualification: Occupation: Contact No.:
4.   Guardian's Name: (only if father is not the guardian)
    Relation with the candidate
    Qualification: Occupation: Contact No.:
5.   Combined Annual Income
6.   Address : (i) Present (Mailing):
    PO Dist. State PIN
    Mobile No *. Alternate No. Email *.
7.   Sibling studying in the institution (Name and Adm. No.):
    (Please note that it is in the interest of the parents/guardians, not to depute a person other than a relative as local guardian.)
8. Attachments  
  1. Birth Certificate (In case of Class Nursery - Ist) :
  2. Transfer Certificate (In case of Class II - IX) :
  3. Last Exam Marksheet (In case of Class II - IX) :

I, hereby declare that my Son/Daugher ................. has my permission to participate in all Co-curricular activities (games, sports, drama, excursions etc.) and other outdoor and indoor activities organised by the school. I hereby permit him/her to use the transportation provided by the school, if needed, and will not hold the committee/school, responsible for any claims resulting from any accidents etc. while coming or going to school or within the school campus. The date of birth mentioned in this form taken from birth certificate/T.C. of my son/daughter is correct and I will not demand any change in the future.

In case of any accident or emergency during a trip/excursion the school will not be held responsible, though I believe the school authorities accompanying the children will be vigilant and extremely alert to avoid any such mishap during school tours, excursions, competitions etc.

I have read the rules and regulations of the school as laid down in the summary of prospectus and agree to abide by them. I hereby agree to abide by all the decisions of the Principal. If my child is found indulging in any indiscipline, whatsoever, the Principal will have the right to punish or expel him/her from the institution and this decision will be final and binding on me. I understant that no third party will be allowed to represent me or my child in any matter.

  1. An incomplete form will be summarily rejected.
  2. Candidate will have to produce Transfer Certificate (Original) at the time of admission.
  3. Please attach the following documents along with the application form:
    1. Transfer Certificate,
    2. Photocopy of marksheet of the last examination attended and annual result of the previous class duly attested by the head of the institution or a gazetted officer,
    3. Birth Certificate