MODERN SCHOOL Vasant Vihar APPLICATION FOR …

1 For Office Use Only Date of Submission _____ MODERN SCHOOL Vasant Vihar Please paste the latest photograph of the child here Registration. No. _____ APPLICATION FOR REGISTRATION PRE- SCHOOL (NURSERY) ACADEMIC SESSION 2018-19 (PLEASE FILL IN BLOCK LETTERS) 1. Please indicate the category to which you are applying with a in the relevant box : Alumni Sibling General 2. Name of the Child _____ Boy / Girl _____ 3. Date of Birth: DD MM YYYY Age as on _____ Date of Birth in words _____ 4. 5. Details of Alumni (Please put a in the appropriate box): Mother Father Grandparent(s) 6. Details of Sibling(s) studying at MODERN SCHOOL , Vasant Vihar : Name of the Sibling(s) Grade Admission No. _____ _____ _____ _____ _____ _____ Please read the instructions overleaf. Certificate from the parent (overleaf) must be signed for acceptance of this form. Incomplete form will not be accepted.

2 Verifying Authority: _____ Approving Authority: _____ Details of Child s Parents : Father Mother Name : _____ _____ Residential Address : _____ _____ _____ _____ _____ _____ Tel No. (Residence) : _____ _____ (Mobile) : _____ _____ E-mail Id : _____ _____ General Instructions: 1. Kindly fill in the form in CAPITAL LETTERS only. 2. Please use only a blue / black ball pen to fill the form. 3. Do not enter the registration number yourself. 4. Use appropriate tick mark as in the relevant box given in section 1 and 5. 5. Please attach the following documents on the day of submission of form. a) Proof of residential address (Photocopy of any one of the following documents is to be enclosed): Ration Card issued in the name of parents (mother/father having name of the child) / Domicile Certificate of child or of his/her parents / Voter ID / MTNL Telephone Bill / Electricity Bill / Water Bill /UID Card / Passport b) Self-attested photocopy of the Date of Birth Certificate of the child.

3 C) In case of sibling applicant, duly signed certificate from the SCHOOL office. d) In case of parent / grandparent being an alumnus, duly signed certificate from the SCHOOL office. 6. Kindly note that the SCHOOL DOES NOT provide transport facility for Pre- SCHOOL (Nursery). CERTIFICATE FROM THE PARENT I / We accept the process of admission undertaken by the SCHOOL and I / we will abide by the decision taken by the SCHOOL authorities. I / We also understand that the APPLICATION /registration/wait listing does not guarantee admission to my/our ward. I / We hereby certify that the above information provided by me / us is correct. I / We understand that if the information is found to be incorrect or false now or later, my / our ward will be automatically debarred from the admission / continuance without any correspondence in this regard. _____ _____ (Signature of Mother) (Signature of Father) Name of Mother _____ Name of Father _____ MODERN SCHOOL Vasant Vihar New Delhi-110 057