PSR No. .............................

1. Name of the Student (in block letters) ........................................................................................

2. Gender Male / Female

3. Mother Tongue .............................................................................................................................

4. Date of Birth Date ............................... Month ............................... Year ...................................

5. Nationality ....................................................................................................................................

6. Religion ……………………………............................…… If Christian Catholic Others (NB: Attach letter of Parish Priest/Pastor)

7. Father’s Name ..............................................................................................................................

Office Address ..............................................................................................................................

E-Mail (if any) ......................................................................... Phone : ........................................

8. Mother’s Name ..............................................................................................................................

Office Address................................................................................................................................

E-Mail (if any) ......................................................................... Phone : ........................................

9. Guardian’s Details ..........................................................................................................................

10. Residential Address (Delhi) ...........................................................................................................

................................................................................................. Phone : ........................................ INFORMATION ON SCHOOL SPECIFIC PARAMETERS : 11. NEIGHBORHOOD : Distance from the school in Savita Vihar (in Kms) .......................................

(NB: Distance fixed by the school will be final).

12. Whether child of ALUMNI Yes No

If 'Yes’ furnish Details Father : Year of passing out ..................... Class .....................

Mother : Year of passing out ..................... Class .....................

13. SIBLING (Whether real Brother/Sister currently studying in St. Joseph’s Academy) Yes No

If 'Yes’, Name ........................………………. Adm. No. .........….. Class …….....…… Section……. 14. Whether GIRL CHILD Yes No 15. Whether child of SINGLE PARENT Yes No

If yes, attach the relevant documents. (Divorcee/Widow/Widower/Spinster)

PHOTO

BAL JYOTIC/o ST. JOSEPH’S ACADEMY

Savita Vihar, Delhi-110092(A Minority Institution)

Registration Form for 2015-2016 for Pre-School (LKG)(Age: The Child shall have completed 3 years on 31st March, 2015)

S. No. ....................

BAL JYOTIC/o ST. JOSEPH’S ACADEMY

Savita Vihar, Delhi-110092(A Minority Institution)

AcknowledgementRegistration Form for 2015-2016 for Pre-School (LKG)

(Age: The Child shall have completed 3 years on 31st March, 2015)

PSR No. .............................

Received registration form of ...................................................... for admission to class Pre-school (LKG) for the session 2015-2016.

Result on 2nd March 2015 at 4:00 p.m.

Date ...................................

Declaration:

I………………………………………………………. father/mother/guardian of………………….. hereby

declare that the information given above are based on facts and authentic records. Admission of

my child may be cancelled if any information is found to be false.

I fully understand that this registration does not guarantee admission and the registration fee is

not refundable.

I also understand that even if my ward is admitted to class “Pre-school” (LKG) BALJYOTI, it does

not in any way guarantee automatic promotion to class Pre-Primary (UKG) and that I will have to

seek fresh admission for my ward to Pre-Primary through a process of admission as per admission

criteria applicable at that time.

Signature

Please Note:

1. Enclose only self-attested copies of the documents with this registration form. Originals will be

checked at the time of admission.

2. Incomplete forms will be rejected.

Date:

Place:

NB: Attach copies of :

1. Birth certificate of the child2. Residential proof (Ration card/Election ID card/Passport/Driving License, Rent Deed attested by

SDM/Adhaar card/UID card/Electricity bill/MTNL telephone bill/water bill/issued in the name any of the parent/Domicile certificate of child or his/her parents).

Please register my son/daughter/ward name above in your Pre-school (LKG) BALJYOTI, which will function from VIII/54, Jwalanagar, Shahadara, Delhi-110032 from 2 p.m. to 5 p.m. I shall produce the originals of the requisite documents at the time of admission for verification.

Return this Form duly filled from 13.01.15 to 20.01.15 on all week days

(As mentioned on the school Notice Board)