ON-LINE REGISTRATION FORM
Academic Session (2022-2023)
Home* Fields are mandatory


Details of the Student
           
*First Name   
    *Last Name
           
*Date of Birth(in figures)        *Date of Birth(in words)
           
*Nationality   
    *Religion
           
*Mother Tongue   
    *Mobile No
           
Phone Number        *Class in which Admission is Sought   
           
*Gender   
           
           
*Age as on 31.03.2022: Year Months Days
           
* Whether SC/ST/OBC
(Certificate to be attached
if applicable)
*Residential Address
*Photograph of Child:



       
           
           
           
Parents's Details Father Mother
       
*Photographs




       
       
       
*Name
       
*Educational Qualification
       
*Profession/Occupation
       
*Designation
       
*Annual Income
       
*Name Of The Organisation
       
*Office Address
       
Telephone Office
       
*Mobile Number
       
*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:
           
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
For Office Use Only
Checked By: Signature: Name:
           
First Click on Print Button Then Submit Your Form