Maharaja Agrasen Model School

CD-Block, Pitampura, Delhi-110034

Website: www.agrasenschool.com E-mail: agrasenschool1985@gmail.com

CBSE Affiliation. No. 2730149 School ID No-1411182

REGISTRATION FORM

Session: 2021-2022

Already Registered

STUDENT'S INFORMATION

First Name
Middle Name
Last Name
Class
Date of Birth
Gender
Category
Nationality
Mother Tongue
Aadhar No
Does the child have any special needs?
If Yes please give details

Father's/Guardian's details

First Name
Middle Name
Last Name
Mobile No.
Email Id
Aadhar No
Is Alumni ?
Father's Year of leaving school

MOTHER'S INFORMATION

First Name
Middle Name
Last Name
Mobile No.
Email Id
Aadhar No
Is Alumni ?
Mother's Year of leaving school

ADDRESS INFORMATION

Present Address
Country
State
City
Postal Code
Residential Phone No.
Permanent Address
Country
State
City
Postal Code
Residential Phone No.

ADDITIONAL INFORMATION

Distance From School
Area
First Child
Siblings studying in this school?
Name
Admission No.
Class

POINT CRITERIA

S.No. Criteria Specifications Range of Points
1 Neighbourhood 0-8 km – (60)
8-10 km – (40)
Above 10 km – (30) 		60
2 Sibling - 20
3 First Child - 10
4 Alumni - 10

UNDERTAKING

  1. I hereby declare that the information given above by me is based on facts and authentic records. I authorize the School to cancel the admission of my ward if any information is found to be false at a later stage.

  2. I will submit the documentary proofs for verification of the above registration details at the time of admission.

    The self-attested print copy of duly filled form along with the copy of the receipt should be dropped in the school drop box from 9 a.m. to 1 p.m. till March 04,2021.