New Admission 2023-24 Page

ONLINE REGISTRATION FOR ADMISSION [ACADEMIC YEAR 2023-24]

Admission for*

Surname*

Name of Pupil*

Father’s Name*

Mother’s Name*

Date of Birth*

day

month

year

Place of Birth*

Mother tongue*

Religion & Caste *

Applicant Name*

First

Last

Middle

Mobile no.*

Alternate mobile no.

Phone No.

Address*

Address Line 1 Address Line 2 City State Postal / Zip Code Country

1/4

Name of the Playgroup attended*

Last school attended*

If any of the sibling presently studying in P. J. Pancholia High School?*

Name of the student*

Class*

Division*

Roll No.*

If school bus facility required?*

2/4

Name of Father*

First

Last

Middle

Father’s mobile*

Educational qualification*

Pls. specify*

Additional qualification

Occupation*

Office Address*

Address Line 1 Address Line 2 City State Postal / Zip Code Country

Office phone no.*

Email ID

Name of Mother*

First

Last

Middle

Mother’s mobile*

Educational qualification.*

Additional qualification.

Occupation.

Office Address:

Address Line 1 Address Line 2 City State Postal / Zip Code Country

Office phone no

3/4

I/We accept the process of admission undertaken by the school and I/We will abide by the decision taken by the school authorities.*

Agree

Do not agree

I/We also understand that the application / registration / wait listing does not guarantee admission to my / our ward.*

Agree

Do not agree

I/We understand that if the information provided by me / us in this registration form is found to be incorrect or false now or later, this application will be automatically debarred from admission without any correspondence in this regard.*

Agree

Do not agree

I/We hereby certify that the information provided by me/us in this form is correct.*

Agree

Do not agree

4/4

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