Last date for submission Serial No.

{An Institution of the Child Education Society (Regd.)} New Delhi

Phase-II Urban Estate, Dugri, Ludhiana -141 013 (Pb.)
Tel. : 0161-2521170
Website : www.bbpsldh.org

APPLICATION FORM
FOR ADMISSION TO CLASS..........
(Session 2019 - 2020)

Instructions :
i) All entries must be written in BLOCK LETTERS in English.
ii) Leave one square Blank between words.
Affix recent
iii) Incomplete or incorrect application is liable to be rejected. passport size
iv) In case space for any information is inadequate, use abbreviations. photograph
v) Tick within box where appropriate, as .

1. Name of the student

Surname/ Last Name First Name

Middle Name

2. Date of Birth

Day Month Year

2.1 Age as on 01.04.201.....

Years Months
3. Sex : Male (M), Female (F)

M F
4. Blood Group

5. Mother Tongue

6. Last school Attended

BRITISH COUNCIL
International School Award
7. Recognised (R)/ Unrecognised (Unr)

R UnR

8. Official Address
Father’s

Pin :
Mother’s

Pin :
9. Permanent Address

Pin :
10. Residential Address

Pin :
11. E-mail Address :
12. Telephone Nos.

Office Residence Mobile

13. Distance from residence to school
Km Mtrs.
14. Parental information (Tick ü
or enter details, as appropriate)
FATHER’S PARTICULARS MOTHER’S PARTICULARS
14.1 Name Name

14.2 Age Age

14.3 SC ST OTHER SC ST OTHER

14.4 Educational Qualification Educational Qualification

14.5 Profession/Occupation Profession/Occupation

SERVICE SERVICE
 Pvt. Govt. Gazetted Pvt. Govt. Gazetted

Yes No Yes No
Designation Designation

Name of Organisation/ Deptt. Name of Organisation/ Deptt.

BUSINESS (Type & Position) BUSINESS (Type & Position)

SELF EMPLOYED (Nature) SELF EMPLOYED (Nature)

14.6 Nationality Nationality

15. Name, Class and Admission No. of brother / sister (not cousins) of the child studying in this school.

S. No. Name Admn. No. Class/Sec

1.
2.

16. For the safety of the students the school doesn’t approve of any private and unauthorized transport. The
GPS enabled school buses fitted with CCTV cameras, hydraulic doors, speed governors, lady attendants
and other safety equipments as per CBSE norms, is the best option for the security of your child.

17. Is there any medical information about your ward which the School should be aware of

Asthma Epilepsy Juvenile Haemophilia Congenital None

Diabetes Heart Problem

18. Are you a single parent ?

Yes No

Completed by _______________________ Date _______________________

__________________________________ __________________________________
(Father’s Signature) (Mother’s Signature)