Select Academic Year 2019-20 2020-21

Select Class 1ST-A 1ST-B 2ND 3RD 4TH 5TH-A

Select Gender... Male Female

Student Category S.T. O.B.C. S.C. Gen.

Class Repeated (If any) Yes No

Note: Complete address of last school with postal code / landmark

Note: Complete reason to change school

Particulars of Father / Guardian #1

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Particulars of Mother / Guardian #2

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Do you require transport services facility for your child?

Has your child been identified with any learning disability?