PROVIDENCE CONVENT HIGH SCHOOL, PACHORE

Dist- Rajgarh, M.P. 465683, Mobile: 9981773002, Affi. No. 1030463
 
APPLICATION FOR ADMISSION  
Session : 2020-2021 Search
SNO.   G.R.No.
       
                                           
                                           
   



 
1. Details of Candidate
Board  
Standard in which admission is sought :
Name of the candidate:    
Surname *
Name *
Father’s Name  
Gender  
Date of Birth (In figure) *
(In words) *
Place of birth  
Mother Tongue  
Religion:     Caste:
Family Id:     Student SSSM ID: *
Adhar(student) *
Bank Account No *    IFSC Code:
Name of Bank  
TC Number     Class Passed:
School last attended, if any  
Nationality  
Full residential address:    
(Add1)  
(Add2)(Locality, Post Taluka)  
(Add3)(Dist, PIN)  
2. About father of the student whose admission is sought:
Name  
Mother Tongue  
Date of Birth
Religion  
Academic Qualification  
Occupation & Designation  
Name of present company/concern working  for  years and  months  
Full office address  
Telephone Number , Mobile No  
3. About mother of the student whose admission is sought:
Name  
Mother Tongue  
Date of Birth
Religion  
Academic Qualification  
Occupation & Designation  
Name of present company/concern working  for  years and  months  
Full office address  
Telephone Number , Mobile No  
4. About Guardian of the student whose admission is sought:
Name  
Mother Tongue  
Date of Birth
Religion  
Academic Qualification  
Occupation & Designation  
Name of present company/concern working  for  years and  months  
Full residential address  
Full office address  
Telephone Number , Mobile No  
5.  Brothers/Sisters studying in this school[attach photocopies of ID cards] :
 
Name
Standard
 
 
i.
ii.
iii.
 
6. Blood group of the child  
7. Last three vaccination taken:
Name
Date
 
i.
ii.
iii.