JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
St. Raphael's Cathedral School, Palakkad
Application for Admission LKG
Sign in to Google
to save your progress.
Learn more
* Indicates required question
1. Name of Pupil ( Block Letters) As Stated in Birth Certificate
*
Your answer
2. Sex
*
Boy
Girl
3. Father's Name (as in Child Birth Certificate)
*
Your answer
Father's Educational Qualification
*
Your answer
Mother's Name (as in Child's Birth Certificate)
*
Your answer
Mother's Educational Qualification
*
Your answer
4.Occupation of Father
*
Your answer
Occupation of Mother
*
Your answer
5.Annual Income of the Family
*
Your answer
6.Address of Parent
*
Your answer
Phone
*
Your answer
Mobile Number
*
Your answer
7. Name, Address & Occupation of Local Guardian in case the pupil does not live with his/her parent
*
Your answer
Local Guardian Phone
*
Your answer
Local Guardian Mobile
*
Your answer
8. Name of School, Standard, Date of Admission, Date of Leaving Previously attended, with time in each...
*
Your answer
9. a) Date of Birth (in figures and words) (Attach Attested Photocopy of Birth Certificate,original to be produced at the time of admission)
*
Your answer
9 .b) No. of completed years and months as on
*
Your answer
10. Nationality and state to which the pupil belongs
*
Your answer
11. Religion and Caste
*
Your answer
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
*
Yes
No
13. Standard to which admission is sought (in words)
*
Your answer
14. Mother tongue of the pupil
*
Your answer
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)
Your answer
18. Is he/she suffering from any other ailment
Yes
No
Clear selection
19. Personal marks of identification, if any
Your answer
20. Name of Brothers & Sisters studying in this school-classes
Your answer
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:.............................................
TO BE FILLED BY THE PRINCIPAL
Date of Admission:.............................. Admission No: .........................
Standard on which admitted: ............... Signature of Principal:.......................
Clear selection
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
Forms
