Enquiry Form

(A Unit of Shivalik Group of Institutions)

Affiliated to Central Board of Secondary Board of Education (C.B.S.E.) New Delhi

{{SchoolEmail}} Website : www.shivalik.edu.in

Registration Form No. SCC/RF/

1	Name of Student :
	(a) Date & Place Of Birth :		{{Enquiry.DOB.split('-')[0][0]}}{{Enquiry.DOB.split('-')[0][1]}} {{Enquiry.DOB.split('-')[1][0]}}{{Enquiry.DOB.split('-')[1][1]}}{{Enquiry.DOB.split('-')[1][2]}} {{Enquiry.DOB.split('-')[2][0]}}{{Enquiry.DOB.split('-')[2][1]}}{{Enquiry.DOB.split('-')[2][2]}}{{Enquiry.DOB.split('-')[2][3]}}
	(b) Sex :	Whether first born :	Age till 31st March :

2	Details of Parents:-	Parent Type:
	Father's Name: (In block letters)	Nationality:	Edu.Qual.:	Occupation & Designation:
	Mother's Name: (In block letters)	Nationality:	Edu.Qual.:	Occupation & Designation:
	Guardian's Name: (In block letters)	Nationality:	Edu.Qual.:	Occupation & Designation:

Religion :

Caste/Sub-Caste :

3	Residential Address :

State :

District :

City :

Telephone No. :
Father's :	Mob.No.:	Alt.No.:
Mother's :	Mob.No.:	Alt.No.:
Email ID :
Father's :
Mother's :

4	Admission sought in class :
5	Previous school's name :

5	(a) Sibling, if any, studying in SHIVALIK : (Tick if Applicable)
	(b) If yes, please give the following details of the sibling:
	Name	Class & Sec.	Admn. No.	Year of Enrolment

6	Whether ward of the school's employee : (Tick if Applicable)
7	Single Parent : (Widow / Widower / Separated) : (Tick if Applicable)
8	Is any of the parent Alumni of the school? : if yes, please give the following details :

	Father :	Year of study :	From	To	Admission No.:
	Mother :	Year of study :	From	To	Admission No.:

9	Is School transport required? : (Tick if Applicable)

	Please register my son/daughter/ward named above in your school. I shall produce the original documents for verification whenever required
	Signature

UNDERTAKING/DECLARATION

I {{Enquiry.Father_Firstname}} Father/Mother/Guardian of {{Enquiry.FirstName}} {{Enquiry.MiddleName}} {{Enquiry.LastName}} hereby solemnly declare that information given above by me is correct to the best of my knowledge and belief. Admission of the child may be cancelled id any information is found to be false/incorrect. I also understand that the use of the school transport is optional and can be availed only on payment of the prescribed charges and subject to availability of seat.

Date:

Signature:

{{SchoolName}}

Affiliated to Central Board of Secondary Board of Education (C.B.S.E.) New Delhi

{{SchoolAddres}} {{SCell}}

Registration Form No. SCC/RF/

UNDERTAKING/DECLARATION