Registration Number

(Registration Fee of Rs. 25/- to be

paid at the time of submission of
duly filled form)

(To be filled by the school)

Form to be downloaded from website
Submission will be offline with Registration fee of Rs. 25/-

SPRINGDALES SCHOOL
Pusa Road, Upper Ridge Road Junction, New Delhi - 110005
Website : www.springdales.com
REGISTRATION FORM
FOR ADMISSION TO PRE-SCHOOL CLASS (NURSERY)

Under General Category, Staff Category and Special Needs Category

2015-16
M
1.

Name of Child _______________________________________

SEX :

10

(10 points allotted for Girl child)

2.

Date of Birth _______________________________________________________________

(Copy of Birth Certificate along with the form to be submitted. Minimum age 3 years on 31.03.2015)

3.

Age as on 01.04.2015

4.

Name of Father ______________________________________________ Age _____________

5.

Name of Mother _____________________________________________ Age _____________

Please affix latest
Passport size
Photograph

Father

____________________ Years

_______________ Months

Please affix latest

Passport size
Photograph

Please affix latest

Passport size
Photograph

Mother

Child

Kindly paste photographs on the copy of the form before submitting the form.

6.

RESIDENCE CRITERIA
Residential Address ___________________________________________________________
___________________________________________________________
Tele No: ______________________________
Email :

20

Mobile: ____________________________

______________________________________________________________________

Children living in the areas as per list of localities hereunder - East Patel Nagar, West Patel Nagar, Rajinder Nagar, Pusa
Road, W.E.A., Pusa Institute, Minto Road, Delhi University, Shankar Vihar will get 20 points.
To counter the trauma of travel we have Kindergarten bus routes. Those covered by Kindergarten bus routes will get 20 points.
Those applicants not living in the neighborhood and area not covered by school bus routes will get 15 points.

Kindly mention what proof of residence has been attached.

Home Town :_ ________________________________________________

7.

Ration Card issued in the Name of the parents (mother/father having the name of the
child)
Domicile certificate of the child or his/her parents
Voter I D of any of the parents
Electricity Bill/ MTNL telephone bill/ Water Bill
Passport in the Name of any of the Parents or child
Aadhaar Card/ UID card issued in the name of any of the parents

SIBLING CRITERIA (Real brother/sister only)

Yes

No

20

If in Springdales give details of the Sibling :

Sibling Name
Class

Section

Unit ( Please Tick ) Pusa

Dhaula Kuan

Kirti Nagar

(Enclose copy of fee bill/report card along with the copy of the form)

8.

Do you have any children studying in other schools? If so, kindly specify.
Name of Real Brother/Sister

9.

Age

School Attending/Attended

School Alumni
20
(Being a established school of long-standing Springdales has a very large alumni. Therefore
this has to be a special category at Springdales. Alumni should have passed class XII from
the school)
Alumni who have passed class X will only be considered in the case of Inter state transfer of parent.
( Attach as Proof Class XII School Leaving Certificate )
Yes
If yes, year of Passing
OSA Membership No
(A) Father
(B) Mother
In case of Springdalian mother, give maiden name.
________________________________________________________________________________
In case you are a life member of the Old Springdalian Association, kindly give
your membership No. and Year of membership.
________________________________________________________________________________
(Old Springdalians are required to submit copies of their character certificates along with the form)

Full points will be given to those alumni who :

(a) Have become members of the Old Springdalians Association at least 3 years prior to this
application. For non Fulfilment of Criteria (a) only 15 points will be granted

10.

Religious/Linguistic Minorities Criteria :

Please state if you belong to any one of the above. If so, which one ?
________________________________________________________________________________
________________________________________________________________________________
(Proofs must be attached along with the copy of the form.

10

In case of Religious Minority Criteria attach certificate from Minority Commission)

NOTE : Our school believes in heterogeneity and celebration of diversity and that the classroom is
a place where children of all communities and should learn and play together. Therefore
we encourage a good mix in our selection.

11.

Single parent Criteria :

For children with single parent : Father / Mother
o
o

Legal Proof of custody of child to be attached

In case of death of Spouse death certificate to be attached

________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
12.

For 1st Born Child (Girl or Boy) not being a sibling or child of an alumnus.
If YES, please submit the following :
(a) Affidavit from Notary Public certifying that the child is a first born.
(b) Birth Certificate of child
(c) Statement from parent certifying information as correct and true.
Please Note : If information is found to be false, the school authorities will cancel the
Admission, if given.

13.

Special Needs Category for differently-abled children : (No points)

Does your child need Special Education facility? If so, enclose authenticated
documents. Children with Special Needs will be admitted if they can produce
a certificate from the appropriate medical specialist that they are ready for inclusive
mainstream education. A maximum of 3% seats available in this category.

__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
14. Staff Category : (No points)
(a) Children of staff members who are permanently employed in the Institution.
(b) Grand Children of Staff members who have attained Superannuation.
Details of employment in the school to be given and years of service.

position, date of employment

___________________________________________________________________________
___________________________________________________________________________
Will be admitted to a maximum of 5% seats under Staff Category. Unfilled seated will be converted to
General Category.

15

INFORMATION ABOUT PARENTS FOR SCHOOL DATA-BASE ONLY

(Please Note : There is no allocation of points in this section)
EDUCATION OF PARENTS :
1.

Father :

____________________________________________________________________

2.

Mother :

___________________________________________________________________

3.

Schools and Colleges attended by both :

_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

4.

Profession/occupation of father :
________________________________________________________________________________

5.

Profession/occupation of mother :
_________________________________________________________________________________

6.

Office Address and Telephone Nos. :

________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

PLEASE NOTE:
1.

This is an application for registration only. Those parents short-listed for verification
of documents will be informed by phone/web site.

2.

Municipal Birth Certificates, Proof of residence and other required documents are
to be submitted by parents along with the form.

3.

Please fill up this form very carefully as information given herein will be considered
for admission of your children.

5.

Please apply at ONE unit only otherwise it will constitute a disqualification.

6.

Our school being co-ed it is desirable to enroll an equal number of girls and boys.
Therefore 10 points have been allocated for the girl child.

7.

This registration form is for admission to Pre-School Class only.

CERTIFICATE FROM THE PARENT

I/We hereby certify that the above information provided by me/us is correct and I/we
understand that if the information is found to be incorrect or false, the ward shall be
automatically debarred from selection/admission process without any correspondence in this
regard. I/we also understand that the application/registration/short listing does not guarantee
admission to my ward. I/we accept the process of admission undertaken by the school and
List will
of documents
submitted
I/we
abide by the
decision taken by the school authorities. In the event of our child being
1.
5. to pay the school fees and transport fees (if
granted admission in the school, I/we guarantee
2.
6. during the year/s.
school
transport is used) as charged by the school
Comments of the Admission Committee and Management
Signature of Father ______________________
Signature of Mother ______________________
List of documents submitted
Name of the Father _____________________
Name of the Mother ______________________
Date :

List of documents submitted

1.
2.
3.

4.
5.
6.
For Internal Use only

Comments of the Admission Committee and Management

Final Decision

______________________________

Signature of Committee Member

Signature of Principal