Pragati It's Different

Student Information

Applicant's Full Name (Block Latters):*

Gender:

Male Female

Date-of-Birth:*

In Words:

Nationality of Child:*

Cast:

Gen OBC SC ST

Place of Birth:

Height:

Weight:

Medical History (If Any):

Parent's Detail

Father's Name (Block Latters):*

Academic Qualification:

Phone:

Mobile:*

Occupation:

Designation:

E-mail:

Mother's Name (Block Latters):

Academic Qualification:

Phone:

Mobile:

Occupation:

Designation:

E-mail:

Residential Address:

House No./Building Name:

Street:

Location:

City:

Pin Code:

State:

Emergency Contact No.

Please indicate who is to be contacted in case of any emergency.

1

Relationship

2

Relationship

Hobby

Field of interest (Cricket/Art/Drama etc.)

Past achievements & participation in competition (Academic/Sports/Co-curricular):

Details Of Applicant's Sibiling(S)

Name

Class:

Section:

*Accept Terms and Conditions

Admission Form