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Form No. : 1572

Application Form for Kg-I Admission

2018-2019

About the Applicant Child

1. Name : KRITEN ANAND

2 a) Date of Birth : 15-Jul-2014 2 b) Gender : Male

(Attested photo copy of the child's birth certificate to be attached)

3. Place of Birth : jamshedpur 4. Nationality/Community : INDIAN

5. Category : GENERAL 6. Religion : Hindu
7. Mother Tongue : Hindi 8. Aadhar No : 368657196786
9. Blood Group : B+
10. Previous School if attended (if any) :
11. Class to which Admission is sought : KG-I

Note : A School Transfer Certificate must be furnished to corroborate item 10

About the Parents / Guardians

1. Full Name of the Father/Guardian : VED PRAKASH LAL DAS

2. Educational Qualification : Diploma in Engineering
3. Occupation & Designation : Engineer(Line Incharge)
(Specific details to be mentioned)
4. Occupational Address :
Phone : Moblie No. : 8092169740
5. Residential Address : Q no- 1, Sales TAX colony, Thakurbari road, Aambagan , Sakchi
Area : Sakchi Pin Code. : 831001 Phone :
6. Full Name of Mother : Prity Das
7. a) Educational Qualification :MCA 7 b) Occupation if any :
Mobile :
8. Processing fee of Rs. 200/- is payable by Online or Order/Demand Draft No.___________________from any
Commercial Bank dtd.____________________on___________________________(name of the bank) in favour of
"D.B.M.S. English School".

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 Other Information to be filled in by Parents / Guardians

1. If own brothers or sisters of the applicant child are studying in this school, their names and classes should
be mentioned here:(Please do not mention names of cousins)

Name Class and Sec of current year

Name Class and Sec of current year
Name Class and Sec of current year
* Please attach a photocopy of the first page of the diary of your own child who is already studying in this school.

2. If the father or mother is an ex-student of D.B.M.S. English School

Name : _________________________________________ Admitted in Std. __________________ Studied upto ____________

No of years in the School ____________ Years. Completed ICSE/ISC from D.B.M.S. English School ____________
(Board) ____________ (Year of Passing).
(Attested photo copy of the child's birth certificate to be attached)

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 IMPORTANT NOTE:
Forms downloaded before 23rd October, 2017 will be invalid.

This form being form No. 1572 was downloaded for the child with the following particulars:

Name of the Applicant Child: KRITEN ANAND

Date of Birth:(DD-MMM-YYYY): 15-Jul-2014 Gender Male
Full name of Father/Guardian: VED PRAKASH LAL DAS

Payment Details :

Form No. Transaction No. Amount Date

1572 245896635 200.00 28-Oct-2017 09:40:21 AM

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Payment Details : For office use only

Form No. : 1572

Name : KRITEN ANAND

Date of Birth : 15-Jul-2014

Gender : Male

Father Name : VED PRAKASH LAL DAS

Mode of Payment : ONLINE

Transaction ID : 245896635

Registration Date & Time : 28-Oct-2017 09:40:21 AM

Form Fee Paid : 200.00

D.B.M.S. ENGLISH SCHOOL

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