Application for Registration
Education and School, Don Bosco Public School
DON BOSCO PUBLIC SCHOOL,
JHIRPA, CHIINDWARA, M.P.
Mobile : 9425040437, 9425645135, 9407537700
 
Website : www.donboscopublicschool.com E-mail : dbpschool@donboscopublicschool.com
Affiliation No. 1030180 School Code : 14034
 
(Application for Registration for Admission)
 
PLEASE FILL IN THE DETAILS IN CAPITAL LETTERS
 
1) Name of Child : (in full) (Capital Letters)
2) Date of Birth :
(Attach Birth Certificate)
3) Student's SSSM ID :(UNMAPPED FROM PREVIOUS SCHOOL)
4). Student's Bank Account Number :     IFSC Code :  
5). Student's Insurance Policy Number :
6). Registration Required for Class :     Year :  
7) School studying at present :
8) Class studying in at Present :     Result :       Grade/ Percent obtained :  
9) Number of years studied in English Medium :
10) Nationality of Parents :     Child:  
11) Religion : Father :     Mother :       Child :  
12) Caste :   Category(SC/ST/OBC/Gen) :( Attach Caste Certificate )
13) School(s)/College(s) attended by Parents : (Please state medium of instruction and qualification)
14) Name of Father :      Occupation :  
15) Name of Mother :      Occupation :  
16) E-mail Address of parents :
17) Phone no. of parents :
18) Language(s) generally spoken at home :
19) Academic attainment of the Child :
20) Extra-Curricular interests of the child :
(Games, hobbies, etc. attach certificate (if any))
21) The child is eldest / middle / youngest child : (Please mention the sex and age of the children)
   
22) Medical Information :( Parents are requested in the interest of their child, not to conceal any information)
   
a. Does your child suffer from or has ever had an episode of: Epileptic seizures/ Asthma/Rheumatic Fever/ Infective Hepatitis/ Primary Complex/ Vertigo
(If so, Please give details-separately, if necessary)  Yes   No 
b.Is there a family history of Diabetes/ Fits/Asthma/Primary Complex ?(If so, please give details- separately, if necessary)  Yes   No 
c.Has your child ever had a head injury or fracture of bones? (If so, please give details)  Yes   No 
d.Does your child wet his bed clothes?  Yes   No 
e.Has your Child undergone any surgery? ( If so, please give details)  Yes   No 
f.Is your child allergic to any medicines? ( If so, please give details)  Yes   No 
g.Does your child require to be given a special diet on medical ground? ( Please attach Doctor\92s certificate)  Yes   No 
h.Does your child suffer from any physical disability which would prevent him from taking part in sports or physical training.
(If so, Please attach the Doctor\92s certificates)  Yes   No 
 
Notes
 
1. The registration fee (Rs. 500) per child is payable along with the hard copy with necessary documents.
2. The registration fee is neither refundable nor transferable.
3. The registration of a child's name on the waiting list does not carry with it the guarantee of admission.
4. Hard copy of SSSM ID/Bank Account / Insurance Policy is necessary to be submitted to the school along with application form.
 
  I have read and Agree to the Terms & Conditions.
Add numbers 6 + 6 =
  Send a copy to me