East West Registeration

EAST WEST PUBLIC SCHOOL

(Permanantly Recognised by the Government of Karnataka)

# 1905/1906, 7th Main, E-Block, 2nd Stage, Rajajinagar, Subramanya Nagar, Bangalore-560 010

E-mail : eastwestschool@yahoo.com Website : eastwestpublicschool.in

REGISTRATION FORM

(2021 - 2022 Nursery to X)

Photograph of Student

Admission to Class

Admission Board

Age as on 30th June 2021

Name of the child (Applicant)(IN BLOCK LETTERS)

Male Female

Date of Birth*

Aadhaar Card #

Date of Birth (In Words)

Nationality

Religion

Mother Tongue

Caste

Others

Blood Group

Second Language (For UKG - X)

Third Language (For Std. V - VIII)

Name and Address of the previous school (not applicable for Nursery)

Submitted Transfer Certificate Yes No

Name

Qualification

Residential Address (please give complete postal address in block letters)

Occupation

Designation

Annual Income

Organization Address

Phone Number

Mobile Number

E-mail(In Block letters only)

Aadhaar Card No.

Landline No.

Locality Code

Distance from School (in Kms) (see below given for distance parameters)

Preferred Mobile Number for School SMS (only one) (Change of Mobile Nos. should be brought to notice of school office)

Siblings Yes No

Sibling's Name (Studing in East West Public School)

If Yes, give details(only of real brothers / sisters) Class / Section

Admission No.

School Alumni (Please fill Details) Yes No

School Staff Yes No

(a) Year of Studying from

Branch

Childs with special needs Yes No

Specify

DECLARATION

I / We hereby certify that the above information provided by me / us is correct and I / We understand that if the information is found to be incorrect or false, the ward shall be automatically debarred from selection / admission process without any correspondence in this regard. I / We also understand that the application / registration / short listing does not guarantee admission to my ward. I / We accept the process of admission undertaken by the school and I / We will abide by the decision taken by the school authorities.

Date

Father Name / Signature

Mother Name / Signature

Whether School Conveyance Required Yes No

Admission Incharge

Principal

Please attach the following	Locality Code	Distance from School
a) Photocopy of Birth Certificate issued by Municipal Corporation	O	0-3 Km
b) 2 Latest passport size colour photographs of the student.	A	Above 3 Km. upto 5 Km.
b) Caste Certificate (Other than General)	B	Above 5 Km. upto 10 Km.
c) Address Proof	C	Above 10 Km. upto 20 Km.
	D	Above 20 Km.

Aadhaar Card

Birth Certificate

Result