Registration

REGISTRATION FORM
(Fields Marked with * are mandatory)

DETAILS ABOUT THE CHILD

Name of the Child  *

Date of Birth (dd/mm/yyyy)*

Previous School( if any)

Last Class attended

Details of learning difficulty (if any)

Sibling(s) - Age and School (if any)

DETAILS ABOUT THE PARENTS * (Preferably both, but one parent's details is mandatory )

Father's Name

Educational Qualification

Mother's Name

Educational Qualification

Father's Occupation

Organization

Mother's Occupation

Organization

Email Address:*
Postal Address:

Enter Code:

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Phone :
Res:               Off:

Mobile(s):  1. 2.

Name of the Child *	Date of Birth (dd/mm/yyyy)*
Previous School( if any)	Last Class attended

Father's Name	Educational Qualification
Mother's Name	Educational Qualification
Father's Occupation	Organization
Mother's Occupation	Organization