New Horizon Public School & Penguin Kids

CBSE Affiliation No. 1130164

Sector-13, Khanda Colony, New Panvel (W), Navi Mumbai -410206

Contact : 27461567 / 27461568

ADMISSION FORM (2019-20)

S. No. .................. G.R. No. ...................................

Saral ID ......................................... Student ID. NHPSPSTD

Shift. .......................................

To,
The Principal,

I am seeking admission for my ward in Grade / Class NURSERY in your School.

1. Pupil's Full Name : MS. KUNJAN RAKSHE

2. Date of Birth : 07/09/2015 Place of Birth : MUMBAI District : MUMBAI

State : MAHARASHTRA

3. Nationality : INDIAN Religion : HINDU Category : GENERAL

Caste : ..................... Mother Tongue : MARATHI

4. Aadhaar Card No : .....................

5. Father's Full Name : MR. SACHIN RAKSHE

Qualification : GRADUATE Occupation : PRIVATE EMPLOYED Annual Income : 2 LACS - 5 LACS

Name of the Organization & Address : DR.SINGH CITY HOSPITAL, KALAMBOLI, SECTOR-4

Mobile : 9987925411 Telephone : ..................... Email ID : sachinrakshe18@gmail.com

6. Mother's Full Name : MRS. RAJASHRI RAKSHE

Qualification : UNDER GRADUATE Occupation : GOVERNMENT EMPLOYED Annual Income : 2 LACS - 5 LACS

Name of the Organization & Address : J.J.HOSPITAL, BYCULLA, MUMBAI

Mobile : 9819117379 Telephone : ..................... Email ID : rajashrirakshe@gmail.com

7. Guardian's Full Name :

Relation with Pupil : .....................

Qualification : ..................... Occupation : ..................... Annual Income : .....................

Name of the Organization & Address : ,

Mobile : ..................... Telephone : ..................... Email ID :

8. Residential Address : ROOM NO-304, TIRUPATI SOCIETY, PLOT NO-21, SECTOR-22, KAMOTHE, NAVI
MUMBAI

Area : KAMOTHE City : PANVEL

PIN Code : 401209 State : MAHARASHTRA

9. Last School Attended : LITTLE SCHOOL HOME

City : ..................... State : MAHARASHTRA

10. Any identification mark on the body : .....................

I hereby declare that I shall cooperate with the school authorities and abide by all the rules and regulations of school and the
information stated above is true to the best of my knowledge.

Father's Signature ............................. Mother's Signature ........................... Guardian Signature .............................

For Office Use Only

MS. KUNJAN RAKSHE having Date of Birth 07/09/2015 is given Provisional / Regular admission in Grade
NURSERY Div._______ on _______/_______/20_______

Documents Received -

Original Birth Certificate / Notarised copy of Birth Certificate (NURSERY - GRADE I)

Original School Leaving Certificate (GRADE II ONWARDS)

Photocopy of Previous Year Report Card (JR. KG ONWARDS)

Authorised Signatory Principal