ON-LINE REGISTRATION FORM
Academic Session (2024-2025)

* Fields are mandatory & Hard Copy of the form along with the documents needs to be submitted in the School.

Details of the Student

Child's Photograph :

Father's Photograph :

Mother's Photograph :

*First Name

*Last Name

*Date of Birth(in figures)

*Date of Birth(in words)

*Nationality

*Religion

*Mother Tongue

*Mobile No

Gender

Male Female

*Class in which Admission is Sought

*Age as on 31.03.2024:

Year

Months

Days

* Whether SC/ST/OBC
(if yes, attach
certificate)

*Residential Address

Parents's Details	Father	Mother

*Name	Father Name*	Mother Name*

*Educational Qualification	Father Education*	Mother Education*

*Profession/Occupation	Father Profession*	Mother Profession*

*Designation

*Annual Income

*Name Of The Organisation

*Office Address

Telephone Office

*Mobile Number	Father Mobile No*

*Email ID

Significant Medical History which the school should be aware of:

Allergies:

Special Notes

1) Height:

2) Weight:

3) Blood Group:

4) Eye Sight (Normal/using spectacles):

5) Hearing (Normal/using hearing aid) :

Requirement of School Bus
Yes
No

Information on parameters

Distance from the School (in Kms)

Details Of Siblings(Please note sibling refers to own brother/sister) studying in Sam International School

	Child-1	Child-2
Name of child
Class
Total Points:

I hereby certify that the information given by me is based on facts and authentic records. I understand that if any of this information is found to be untrue, this application will be cancelled. I shall abide by rules and regulations of the school in all manners.

Signature of
Father :	Mother :	Local Guardian:

INSTRUCTIONS

1) Incomplete / Invalid forms will be rejected.

2) This is a Registration form and does not in any way entitle the candidate to admission.

3)Due to limited number of seats, it will not be possible to admit all the children who apply

4)School buses are plying on specific routes.

5)Please submit self attested copies of the following with the application:

a)Birth certificate issued by the Municipal Corporation.

b) Proof of residence (Copy of Voter Card/Ration card/Passport)

c) Medical certificate

d) Copy of Aadhar Card Mother, Father & child.

e)Progress Report of previous year.

f)Original Transfer Certificate(if selected)

g)Photograpghs of Mother & Father and the child(2 Each)

For Office Use Only
Checked By:	Signature:	Name:

First Click on Print Button Then Submit Your Form