S.NO.

____________

(Registration Fee of Rs. 25/- to be

paid at the time of submission of
duly filled form)

Form to be downloaded from website

Submission will be offline with Registration fee of Rs.
25/-

SPRINGDALES SCHOOL
A 44, Kirti Nagar, New Delhi - 110015
Website : www.springdales.com
REGISTRATION FORM
FOR ADMISSION TO PRE-SCHOOL CLASS (NURSERY)

Under General Category and Staff Category

2014-15
M
1.

Name of Child _______________________________________

SEX :

(5% of the total number of seats have been allocated to the Girl child)

2.

Date of Birth _______________________________________________________________

(Copy of Birth Certificate along with the form to be submitted. Minimum age 3 years on 31.03.2014)

3.

Age as on 01.04.2014

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 :

Mobile: ____________________________

______________________________________________________________________

Please mention distance of place of residence from school in kms.

___________________________________________________________
Kindly mention what proof of residence has been attached.
(Also kindly attach copy of google map as proof of distance of residence from school)

70

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

7.

SIBLING CRITERIA (Real brother/sister only)

Yes

No

20

Details of sibling studying in Springdales Schools :

Sibling Name
Class-Section
(Enclose copy of fee bill/report card along with the copy of the form)

8.

ALUMNI CRITERIA

School Alumni

Yes

If yes, year of Passing

NO

(A) Father
(B) Mother
In case of Springdalian mother, give maiden name.
________________________________________________________________________________
(Alumni are required to submit copies of their character certificates along with the form as proof)

9. Inter-State Transfers :
For children of parents who have taken up residence in Delhi and will be applying
In the current session.
(Details and proof to be given regarding transfers)

10. Staff Category

(5% of the total number of seats have been allocated under staff category (Children /
grandchildren)
Children/Grandchildren of staff members who are in the Institution will be admitted
upto a maximum of 5% of seats. Details of employment in the school to be given position, date of employment and years of service.

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

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.

2.

This is an application for registration only. Those parents short-listed for verification
of documents will be informed by phone/web site/ list displayed on board outside
the school.
Municipal Birth Certificates, Proof of residence (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.

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.

4.

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
as per thesubmitted
guidelines of Directorate of Education Circular No :F.DE.15/ActList of documents
I/2013/12810-20
and amendment order F/DE/15/1031/ACT/2013/2096-3007
. I/we will abide
1.
5.
by2. the decision. In the event of our child being
granted admission in the school, I/we
6.
guarantee to pay the school fees and transport fees (if school transport is used) as charged
by
the school
the year/s.
Comments
of during
the Admission
Committee and Management
List of documents submitted
Signature of Father ______________________

Signature of Mother ______________________

Name of the Father _____________________

Name of the Mother ______________________

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

Acknowledgement
Received Registration Form No.______________ (to be filled in by the office at the time of
submission of duly filled form) for admission to Pre-School Class (Nursery) Session 2014-15.

Date : _______________

Signature of staff
Springdales School, Kirti Nagar