REGISTRATION FORM

PART-A [PERSONAL DETAILS]
Name of Ward/Child :
Mother's Full Name of Child :
Father's Full Name of Child :
Gender of Child :
Date of Birth of Child :
Aadhar No of Child :
Parivar Pehchan Patra (PPP/Family ID) No:
Mobile (Please provide valid parents number and not any Cybercafe or CSC Centre Mobile) :	Alternate Mobile Note: This number will be used for future references.
E-mail :
Apply for Class :	(Change carefully, this will remove your saved school choices)
Apply Under Category (EWS/Dis-Advantage Group) :

PART-B [ADDRESS DETAILS]
State :
District :	(Change carefully, this will remove your saved school choices)
Block Name :
City/Village Name :
Address :
PinCode :

PART-C [PHOTOGRAPH & SIGNATURE (Note:- Both Photograph and Signature are mandatory before going to next page)]
PHOTOGRAPH OF THE STUDENT	SIGNATURE OF THE PARENT
Click on below image to upload the passport size photo of the Student	Click on below image to upload the signature photo