JP ACADEMY
Shapping A New Future
 
  Registration Form
 
Academic Session * :
     
Class Sought for Admission * :
Name of the Child * :
Date of Birth * : Pick a date
Place of Birth :
Nationality * :
Religion :
Sex : Male Female
Caste :
RECORD OF PREVIOUS EDUCATION :
S. No. School Attended Medium of Instruction Year Exams Passed Reason for Leaving the School
1.
2.
3.
4.
5.
 
Mention Hobbies / Interests / Games and Sports / Prizes won.
Has the Child been removed from any other school for disciplinary or academic reason.     Yes No
If yes, Please give details
Name of Father and / or Mother * :
Occupation of Father / Mother :
Office and Designation :
Telephone No. (Office/Residence) :
Full Postal Address of Parent with Telephone No. (Residence) *
Permanent Home Address
Upload Photograph :
    
 
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