UNIVERSAL CONVENT SENIOR SECONDARY SCHOOL

Affilliated To CBSE New Delhi

RTO Road, Kusumkhera, Haldwani(Nainital) Uttarakhand
05946-261095, 261730, 9837745194
Email: universal.convent@rediff mail.com
School Code : 57030
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1. (a) Name of the child in full (in capital letters)  

(b) Sex : Male Female
2. Date of Birth Year Month Day

In word  
Age of the student as on 31st march Year Month Day:
 
3. Blood Group of the Child  
4. Do You Belong to Gen/SC/ST/OBC/EWS/Disabled/S.G. Child? attach certificate.put () which is correct in following :
Gen. Cat.
SC
ST
OBC
EWS
Disabled
SG Child
5. Detalis Of Parents
Deatails of Mother/Father Mother Father
Name (In Capital letter)    
Nationality & Occupation    
Name of Office & Full address with Telephone No.    
Office addreess Telephone No.    
Full residential address with Telephone No.    
residential address with Telephone No.    
Permanent Address    
Annual Income in (Rs.)    
6. Name & Address of local guardian (if any)  
7. Address of local guardian (if any)      
8. Last School Name              
9. last School Address           
10. last attended with Class      
11. Whether Last school was CBSE affiliated  
12. if, the last school is not affiliated with CBSE, specify name of the Board  
13.
(a) Result of last examination  
(b) Percentage  

14. Subjects Proposed to offer
(1)  
(2)  
(3)  
(4)  
(5)  
(6)  


15. Whether the transfer certificate is attached Yes/No Date of T.C  
16. Mother tongue   Home town  

17. Whether the transfer certificate is attached Yes/No
18. Aadhar No.  

DECLARTION BY THE PARENTS
I shall abide by the rules of the Vidyalaya

Date  
Signature Of Parents