CHINMAYA VIDYALAYA P-201, VIDYA NAGAR, POST: SARAVALI, BOISAR-401501 Doc. NO. : CVT/MR/12 Rev. No. & Date : 00 / 01. 08.2011 REGISTRATION FORM

Name of the child

:

Date of Birth

: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Name of the Father

:

Name of the Mother

:

Residential Address

:

Contact Phone No (s)

:

Office Address

:

Contact Phone No (s)

:

Class in which admission is sought

:

The name of the school in which the child is presently studying

:

Board of Education

: C.B.S.E. STATE I.C.S.E.

Sibling : Real brother/ sister only

: Yes No

If Sibling in Chinmaya Vidyalaya give details

:

Class Section

:

Child with special needs [Enclose authenticated documents]

: Yes No

Distance of the school from residence

:

DD No. (DD In favour of CCMT A/C CHINMAYA VIDYALAYA TARAPUR)

:

Bank Name

: Date