TAKSHSHILA INTERNATIONAL EDUCATION CENTER

School code-70777

Late R.S Chaurasia

Registration Form

Name of Pupil(IN BLOCK LETTERS)
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Date of Birth
Mother’s Name(IN BLOCK LETTERS)
Qualification	Occupation
Mother/Father’s Name(IN BLOCK LETTERS)
Qualification	Occupation Annual Income
Guardian's Name(In Capital Letter)
Qualification	Occupation Annual Income
Nationality	Religion
Caste Category	Sub-Category
Handicapped	Yes No
Sex	Male Female
School/Class in which the pupil last studies
Class	Board Percentage Exam
Medium
Address
Whether any sibling/s studying in this school?	Yes No
If Yes,
Name of the child	Class Section
Permanent Address
Pin Code	Phone Mobile
Residential Address
Pin Code	Phone Mobile
Distance from the school (in KMS)
Conveyance required or not
Date of Registration	Class
Upload Signature
	I hereby declare that the above particulars furnished by me are true and correct. I have carefully gone though the instruction and conditions, understood them, and agree to abide by them. I agree that the school authority have every right to take appropriate action, if the documents are found to be false or forged.