St. Raphael's Cathedral School, Palakkad
                                                                      Application for Admission UKG-VIII
Sign in to Google to save your progress. Learn more
1. Name of Pupil ( Block Letters) As Stated in Birth Certificate *
2. Sex *
3. Father's Name (as in Child Birth Certificate) *
Father's Educational Qualification *
Mother's Name  (as in Child's Birth Certificate) *
Mother's Educational Qualification *
4.Occupation of Father *
Occupation of Mother *
5.Annual Income of the Family *
6.Address of Parent *
Phone *
Mobile Number *
7. Name, Address & Occupation of Local Guardian in case the pupil does not live with his/her parent *
Local Guardian Phone *
Local Guardian Mobile *
8. Name of School,Standard,Date of Admission,Date of Leaving Previously attended, with time in each... *
9. a) Date of Birth (in figures and words)    (Attach Attested Photocopy of Birth Certificate,original to be produced at the time of admission)                                                                                             *
9 .b) No. of completed years and months as on *
10. Nationality and state to which the pupil belongs *
11. Religion and Caste *
12. Does the candidate belongs to the Scheduled castes Tributes or Other Backward Communities or is he/she a convert from Scheduled Tribes? if yes Produce caste certificate *
13. Standard to which admission is sought (in words) *
14. Mother tongue of the pupil *
15. No. and date of transfer certificate produced on admission
MM
/
DD
/
YYYY
16. Date of last Vaccination
MM
/
DD
/
YYYY
17. Whether immunised from Tetanus,Diphtheria,Measles Polio and B.C.G (given details)
18. Is he/she suffering from any other ailment
Clear selection
19. Personal marks of identification, if any
20. Name of Brothers & Sisters studying in this school-classes
                                                             DECLARATION
I have read the rules of discipline of this school and undertake that my ward will abide by them. I solemnly declare that the above particulars are true and correct                                                                                      
 

Station:...................................
Date:.......................................

                                                                                                          Siganture of Parent (Responsible Guardian)
                                               TO BE FILLED BY THE PRINCIPAL
Date of Admission:...............................................                       Admission No: ...........................................

Standard on which admitted: ...............................

                                                                                                         Signature of Principal:...................................

Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms