Registration No. ....Session... SI.No. ..

ADMISSION FORM
ST. TERESAS DAY SCHOOL & COLLEGE
109/4, MODEL HOUSE, LUCKNOW-226 001

Nursery/ Kindergarten/ Preparatory/ Classes I, II, III, IV, V, VI, VII, VIII, IX, X, XI & XII

PHOTO

(Please attach two photographs and a copy of the Birth Certificate)

(POSSISION OF THE FORM DOES NOT GUARANTEE ADMISSION)
1.

Name of pupil....
(First Name)
(Middle Name)
(Last Name)
Gender- Male... Female ...
2. Date of Birth..... Nationality ..
3. Parents DetailsFather ..Qualification ... Blood Group .......
Occupation .Designation ...Department ..Monthly Income..
Mother ... Qualification ... Blood Group ........
Occupation .Designation ...Department ..Monthly Income..
OR
Guardians Name .
Residential Address ..
Telephone/ Mobile No. & E-mail .
Emergency Contact No. ...
4. Complete Local Address ..
...
5. Telephone No. .... Office Residence .
6. Class of which admission is sought
7. Previous School attended
8. Duration ..
9. Last Report Card submitted .
10. Whether the pupil ever attended this institution? If so mention the year and class
...
11. Any of the childs brothers and sisters studying in this institution?
Mention Name & Class .
12. Language spoken by pupil ...
13. Religion/ Caste .....{SC/ ST/ OBC/ GEN (enclose certificate)}
14. Is there anything in your childs development that we should know ................
...
15. List any special interest or hobbies of the child ...
...
16. List of Certificates received by the child ....
(Name of Father) agree to abide by the rules of St. Teresas Day
School & College. Rules are subject to change from time to time. I have personally verified the date of
birth given above and certify that is correct.
Date.
Signature of Parents/ Guardian .
Fees Paid ..
Date ...
FOR OFFICIAL USE ONLY
TEST AND INTERVIEW REPORT
Name of pupil ...Class ...... Date .
Date of Birth . Fees Paid .... Date ..
SI. No.
Subject
Marks Obtained
Remarks and Signature
1.
Hindi
2.
Math
3.
English
Birth Certificate submitted Original/ Duplicate .
Admission GRANTED/ REFUSED
Class .... Date ....
Signature of Class Teacher
Signature of Principal
..
..
Regd. No. .. Class ..
SI. No.
You are hereby expected to attend and interview on .
Date of Exams: Hindi
Math
English
For PRINCIPAL