CHAVARA ICSE SCHOOL

MOHIDA ROAD, CHAVARA NAGAR, SHAHADA

2024-2025

Application Form

Monday, November 18, 2024

1. Details of Candidate

School*

Class*

Surname

Name*

Father’s Name*

Gender

Male

Female

Date Of Birth*

Date Of Birth (In words)*

Place of birth

Mother Tongue*

Religion

Caste

(attach copy of cast certificate)

Nationality

School last attended

Full Residential Address :

(Add1)

(Add2)(Locality, Post Taluka)

(Add3)(Dist, PIN)

2. About father of the student whose admission is sought:

Name

Mother Tongue

Date Of Birth

Religion

Academic Qualification

Occupation & Designation

Name of present company/concern working

for

years

months

Full office address

Telephone Number

Mobile Number *

3. About mother of the student whose admission is sought:

Name

Mother Tongue

Date Of Birth

Religion

Academic Qualification

Occupation & Designation

Name of present company/concern working

for

years

months

Full office address

Telephone Number

Mobile Number *

4. About Guardian of the student whose admission is sought:

Name

Mother Tongue

Date Of Birth

Religion

Academic Qualification

Occupation & Designation

Name of present company/concern working

for

years

months

Full residential address

Full office address

Monthly income

Telephone Number

Mobile Number

5. Brothers/Sisters studying in this school[attach photocopies of ID cards] :

	Name	Standard
i.
ii.
iii.

6. Whether your child avail school's transport

Yes

7. Blood group of the child

8. Last three vaccination taken:

	Name	Date
i.
ii.
iii.