Student Data

STUDENT DATA

ADMISSIONS 2007Affix a recent

Passport-size colour

Photograph

of the candidate

FORM NO.DATE OF ISSUE CLASS

REGISTRATION NO.

USE ONLY CAPITAL LETTERS / Please do not leave any column blank / Use N.A. wherever necessary.

NAME: ____________________________________________________________________________________________

FIRST

MIDDLE

LAST

DATE OF BIRTH

MALE FEMALE

dd

mm

yyyy

DATE OF BIRTH ____________________________________________________________________________________

(IN WORDS)

PLACE OF BIRTH ___________________________________________________________________________________

AGE AS ON 30-09-2007 YEARS MONTHS DAYSADMISSION SOUGHT IN CLASS ______________________________________________________________________

(IN WORDS)

PRESENT SCHOOL __________________________________________ PRESENT CLASS _____________________

BOARD AFFILIATED TO _____________________________ MEDIUM OF INSTRUCTION ______________________RESIDENTIAL ADDRESS: ________________________ D.No.______________ STREET ________________________

LANDMARK _________________________________ CITY ___________________________

STATE ___________________ PIN CODE ___________________TELEPHONE NO. _________________________, __________________________, MOBILE NO. ___________________

EMAIL ______________________________________________________________________________________________

NATIONALITY __________________________________ MOTHER TONGUE ___________________________________

DETAILS OF SIBLINGS

(REAL BROTHER / SISTER WHO ARE STUDYING OR HAVE APPLIED FOR ADMISSION AT DPS VIJAYAWADA)

Sibling 1

Sibling 2

Name _____________________________________ _______________________________________________

Class _____________________________________ _______________________________________________

ADMISSION / REGISTRATION NO.

PARENT DATA

FATHER

MOTHER

NAME ____________________________________ _________________________________________

DATE OF BIRTH ____________________________________ _________________________________________

QUALIFICATION ____________________________________ _________________________________________

NATIONALITY ____________________ RELIGION ____________________ CASTE: OC / BC / SC / ST

OCCUPATION BUSINESS SERVICE PROFESSION BUSINESS SERVICE PROFESSION

NATURE OF

OCCUPATION ______________________________________ _________________________________________

NAME OF

ORGANISATION ______________________________________ _________________________________________

DESIGNATION ______________________________________ _________________________________________OFFICE ADDRESS ______________________________________ _________________________________________

______________________________________ _________________________________________

PHONE(S) ______________________________________ _________________________________________

MOBILE NO. ______________________________________ _________________________________________

e- Mail ID: ______________________________________ _________________________________________

NO. OF CHILDREN: DAUGHTERS

SON/S

TRANSPORT

TRANSPORT REQUIRED: YES

NO

BUS STOP LOCATION:PREFERENCE 1 ____________________ PREFERENCE 2 ____________________

IN THE EVENT TRANSPORT FACILITY IS NOT AVAILABLE, WILL YOU SEEK ADMISSION: YES NO PARENTAL CONTRIBUTION

AREA OF INTEREST WHERE PARENTAL CONTRIBUTION COULD ENRICH THE SCHOOL

MUSIC / DANCE / DRAMA

SOCIAL SKILLS

PAINTING / SCULPTURE

ACADEMICS

PUBLIC SPEAKING

CAREER COUSELLING

MEDICAL SERVICE

MEDIA / PUBLIC RELATION

SPORTS

OTHER AREAS

COMMUNITY PROGRAMME

DECLARATION:We hereby certify that the information given above is true and correct to the best of my knowledge. If my / our son / daughter is selected for admission, I hereby agree and give consent to abide by the rules and regulations of the school. We also understand and agree that the registration of my / our child does not guarantee him / her admission to the school and that the Registration Fee is neither transferable nor refundable.

DATE: ____________.DOCUMENTS ATTACHED

Photocopy of Birth Certificate

Photocopy of Last Progress Report___________________

___________________

_____________________MOTHERS SIGNATURE

FATHERS SIGNATURE

GUARDIANS SIGNATURE

(RELATION SHIP) FOR OFFICE USE

ADMISSIONS 2007

ADMITTED

NOT ADMITTED

CLASS: _____________________________ SECTION: _____________________ W.E.F.: ___________________________

ENCLOSURES

PHOTOGRAPH OF STUDENT

TRANSFER CERTIFICATE

PARENTS PHOTOGRAPH

INDEMNITY BOND

BIRTH CERTIFICATE

MEDICAL CERTIFICATE

PREVIOUS YEARS PROGRESS REPORT

ADMISSION NO:

DOCUMENTS VERIFIED BY _________________________________________

PARENT ADMIT CARD

ADMISSIONS 2007

REGISTRATION NO.

CLASS

Name of the Child ___________________________________________

Date and Time of Interaction ________________________________

Venue of Interaction:

NOTE:Parents should show the Parent Admit Card to receive their child after the

observation / written test and at the time Interaction.

SCHOOL SEALDELHI PUBLIC SCHOOL VIJAYAWADACANDIDATES IDENTITY CARD

REGISTRATION NO.

CLASS

Name of the Child _________________________________________________________CANDIDATES ADMIT CARD

ADMISSIONS 2007

REGISTRATION NO.

CLASS

Name of the Child _____________________________________________

Date and Time of observation / written test _________________________Venue of Observation / Written TestNote:No candidate will be allowed to take the test without the candidate

Admit card. Also, the parents should produce the Parent Admit Card to

Receive their child after the Observation / Written test.

SCHOOL SEALGENERAL INFORMATION

ADMISSIONS 2007INSTRUCTIONS FOR PARENTS

1. The Registration Form is to be filled and submitted to the Administrative Office within three days of issue of the Registration Form.

2. Incomplete or illegible Registration Forms will not be accepted.

3. Date for Tests / Observation and Interaction will be given at the time of Registration and the same may be changed, without prior notice, by the school authority.

4. Registration does not imply admission. Admission is subject to the results of the Admission Test and Interaction and the availability of seats.

5. At the time of Registration please pay the prescribed fee for the Registration and Processing in cash at the Administrative Office, with the following documents.

a) The completed and signed Registration Form.

b) Four passport-size colour photographs pasted at the appropriate places in the forms.

c) Photocopy of proof of Date of Birth (issued by the Municipal Corporation, village Panchayat Officer or any competent authority). Of candidates seeking admission to classes L.K.G. (Nursery) to Class I. Date of Birth certificate issued by Doctors / Nursing homes / Hospitals will not be accepted.d) Photocopy of Progress Report Card (From U.K.G. onwards).

e) Admit Cards (Two).

f) Candidates Identity Card.

6. Admission to Nursery and Preparatory classes will be through Observation / Interaction only.7. There will be a Written Test for students seeking admission to Classes I to VII. Only the candidates who clear the written test will be called for an Interaction.

8. Both parents should be present at the time of Observation / Interaction.9. The parents must fill the Registration Form themselves. In case the form is filled by guardians, it should be clearly indicated.

10. Syllabus for the Written Test will be given at the time of Registration.

11. The list of successful candidates at each stage will be posted on the notice board at the Administrative Office and on the school website www.dpsvijayawada.com.12. Parents should stay in touch with the school administration for any communication during the admission process. In case a student wants to withdraw from the school after having taken admission, or seeks admission in any other DPS only the caution deposit will be refunded.

INSTRUCTIONS FOR CANDIDATES

1. Both copies of Admit Cards should be brought at the time of the Admission Test / Observation.

2. Parents must carry their Admit Cards at all times during the admission process.

3. When the candidates go in for the Written Test, they should give their Admit Cards to the Teacher-in-charge of Written Test.

4. The candidates should reach the venue 30 minutes before the scheduled time to allow for time to settle in.

5. Candidates should bring their own stationery like pencils / pens / colour pencils / geometry box etc.

MEDICAL REPORT

ADMISSIONS 2007STUDENT PARTICULARS

Name__________________________________________________ Sex ________________________

Fathers Name _____________________________________ Mothers Name _____________________

REGISTRATION NO.

ADMISSION NO.

CLASSIdentification Marks 1.________________________________, 2. _______________________________1. Height (cm) _________ 2. Weight (Kg) ________ 3. Blood Group ______ 4. HB % ____________

History of any significant past or present illness / prolonged illness

Is there any significant condition the school needs to be aware of about your childs health?GENERAL MEDICAL RECORD

Respiratory System _____________________________________Skin _________________________________________

Heart (CVS) _____________________________________Skeletal system ________________________________

Liver ______________________________________Permanent / Congenital deformity _________________

Spleen ______________________________________Dental condition _______________________________

Other ___________________________________________________________________________________

CNS ______________________________________Is your child allergic to:__________________________

Ear ______________________________________Any medicine? ________________________________

Nose ______________________________________Any food? ____________________________________

Throat ______________________________________Anything else? ________________________________

Eyes ______________________________________Remark / Suggestions ___________________________

_____________________________________________MEDICAL REPORT

ADMISSIONS 2007Does your child wear spectacles? YES / NOIf yes, what is the power of the spectacles? _________The immunisation record is complete. YES / NO

Does your child suffer from colour blindness of any kind?

YES / NODATE: ___________

____________________

Doctors Signature

And Seal

IMMUNISATION RECORD

_______________________________________________________________________________

BCG

DPT Dose 1

Typhoid Dose 1

_______________________________________________________________________________

Oral Polio Dose 1

DPT Dose 2

Typhoid Dose 2

_______________________________________________________________________________

Oral Polio Dose 2

DPT Dose 3

Hepatitus B Dose 1

_______________________________________________________________________________

Oral Polio Dose 3

DPT Booster Dose 1

Hepatitus B Dose 2

_______________________________________________________________________________

Oral Polio Dose 4

DPT Booster Dose 2

Hepatitus B Dose 3_______________________________________________________________________________

Oral Polio Dose 5

HIB Dose 1

Hepatitus A Dose 1

_______________________________________________________________________________

Measles

HIB Dose 2

Hepatitus A Dose 2

______________________________________________________________________________ MMR

HIB Dose 3

Chicken Pox

__________________________

HIB Booster Dose

PRE-ADMISSION CHECKLIST

ADMISSIONS 2007

REGISTRATION NO.

CLASS

Name _____________________________________________________________________________

The following instructions are to be followed strictly in order to complete the admission formalities.

Requisite Fee

Photographs and Documents

(a) Two recent passport-size colour photographs of the candidate. Please take care that the children are not photographed in any school uniform.

(b) One recent postcard-size colour photograph of the candidates parents together, without the candidate.(c) Parent Admit Card.

(d) Transfer Certificate or School Leaving Certificate and Progress Report of the last class attended by the Candidates of Classes II onwards (To be submitted before the start of academic session at our administrative office).

Please note: The Transfer or School Leaving Certificate must be authenticated by the Education Department or concerned Board.

(e) Birth certificate for candidate of Nursery to Class I.(f) Pre-admission Medical Check up Form issued by the doctor authorised for this purpose by DPS Vijayawada.

(g) Indemnity Bond (To be provided by the school at the time of admission).

PRE-ADMISSION CHECKLIST

ADMISSIONS 2007PLEASE NOTE

(a)Both the Parents are instructed to be present at the time of conducting the admission process.

(b)If Transport facility is to be availed, ensure that bus charges are paid at the time of the admission as the Transport Fee in the Month of May 2007. Limited seats are available on first-come first-serve basis. Transport facility once taken, has to be continued at least till the end of the academic year.

(c)All mentioned formalities are to be executed at our Administrative Office at Plot No.9, Road No.11, Bharathi Nagar, Opp. To Vinayak Theatre, Vijayawada 8, Tel: 0866-6593333 / 6594444.(d)Please ensure that the admission procedure and medical check up is completed in time. Failure to do so will lead to automatic cancellation of admission.

ADMISSION DATE ______________________________ TIME ______________________________

PRE-ADMISSION MEDICAL CHECKUPThe candidate has to undergo the mandatory medical check-up at

On __________________________________________ at ______________________________________

Please produce the tear-away Pre-admission Medical Check-up Acknowledgement Slip printed below.

Do not make any payments.

Please bring your childs immunization card, blood group and haemoglobin count report at the time of check-up.

PRE-ADMISSION MEDICAL CHECKUP ACKNOWLEDGEMENT SLIP

REGISTRATION NO.

NAME OF CHILD _____________________________________________________________________FATHERS NAME ____________________________ MOTHERS NAME _______________________

DATE ______________________________

TIME ______________________________

____________________________________________

SIGNATURE AND STAMP OF DOCTOR

FEE STRUCTURE (UPTO CLASS VII)

ADMISSIONS 2007FEE BREAK-UPTYPEFREQUENCYPAYABLEAMOUNT

Note: The school reserves the right to revise the fees as determined by the Schools Board of Management. The fee revision will be linked with the national cost of living index and current inflation rates which may amount to an increase of 8-10% annually.

ADMISSION SCHEDULE

ISSUE OF REGISTRATION FORMS

: ________________________________________REGISTRATION PROCESS

: ________________________________________OBSERVATION / INTERACTION (L.K.G.): ________________________________________RESULT (L.K.G.)

: ________________________________________ADMISSION PROCESS (L.K.G.)

: ________________________________________WRITTEN TEST (U.K.G. TO VII)

: ________________________________________RESULT OF WRITTEN TEST (U.K.G. TO VII) : ________________________________________INTERACTION (U.K.G. TO VII)

: ________________________________________FINAL RESULT (U.K.G. TO VII)

: ________________________________________ADMISSION PROCESS (U.K.G. TO VII): ________________________________________BUS ROUTES

ADMISSIONS 2007FOR L.K.G. TO CLASS VII

REMARKS:

SIGNATURE OF THE HEAD MASTER

Affix a recent

Passport-size colour

Photograph of the

Candidate

Affix a recent

Passport-size colour

Photograph of the

Candidate

Affix a recent

Passport-size colour

Photograph of the

Candidate