Shri Ram Centennial School
Sikandarpur Dayalbagh, Agra, U.P. 282005
Tel: 8273037002, 8191800969 | Email: srcs.agra@gmail.com
Registration Form
Note: All '
*
' marked fields are mandatory. Please mention
'NA'
if not applicable.
Sibling Details
Sibling
Admission No.
*
Sibling Name
Sibling Class
Student Details
Name of the Student
*
Middle Name
Last Name
*
Gender
*
--Select Gender--
Male
Female
Date of Birth
*
Place of Birth
Blood group
--Select Blood Group--
O-
O+
A+
A-
B-
B+
AB-
AB+
Photo
*
Admission sought in class
*
--Select Class--
KN- Buds/ 2021-22
KN-Flower/ 2021-22
KN-Nursery/ 2021-22
Nur/ 2021-22
KG/ 2021-22
I/ 2021-22
II/ 2021-22
III/ 2021-22
IV/ 2021-22
V/ 2021-22
VI/ 2021-22
VII/ 2021-22
VIII/ 2021-22
IX/ 2021-22
X/ 2021-22
XI/ 2021-22
XII/ 2021-22
KN-Buds/ 2020-21
KN-Flower/ 2020-21
KN-Nursery/ 2020-21
Nur/ 2020-21
KG/ 2020-21
I/ 2020-21
II/ 2020-21
III/ 2020-21
IV/ 2020-21
V/ 2020-21
VI/ 2020-21
VII/ 2020-21
VIII/ 2020-21
IX/ 2020-21
X/ 2020-21
XI/ 2020-21
XII/ 2020-21
Child's Nationality
Mother Tongue
Category
*
--Select Category--
EWS
GENERAL
OBC
SC/ST
STAFF
Religion
--Select Religion--
Buddhist
Christian
Hindu
Jainism
Muslim
Others
Sikh
Adhaar Card
Mobile no.
*
Email
*
Correspondence Address:
Address
Country
City
State
Pin Code
Distance from the school in Kms :
Permanent Address:
Address
*
Country
City
*
State
*
Pin Code
Nearest Rly. Station/ Airport
Residence phone no.
Mobile no.
Parent Details:
Mother
Name
*
Age
Educational Qualification
*
--Select Qualification--
10th
12th
GRADUATION
POST GRADUATION
Occupation
--Select Profession--
BUSINESS
OTHER
SERVICE
Designation
Organisation
Annual Income
Phone(Off.)
Address(Off.)
E-mail
*
Mobile no.
*
Photo
*
Father
Name
*
Age
Educational Qualification
*
--Select Qualification--
10th
12th
GRADUATION
POST GRADUATION
Occupation
--Select Profession--
BUSINESS
OTHER
SERVICE
Designation
Organisation
Annual Income
Phone(Off.)
Address(Off.)
E-mail
*
Mobile no.
*
Photo
*