Student's Name (IN BLOCK LETTERS)

• First Name
• Middle Name
• Last Name

Date of Birth

• Nepali Date (BS)
• English Date (AD)
• Gender
  Male     Female

• Address
• Admission for Grade Select Grade... Nursery L.K.G U.K.G Class 1 Class 2 Class 3 Class 4 Class 5 Class 6 Class 7 Class 8 Class 9 Class 10 Class 11 Class 12
• Name of the school last attended

Local Guardian/Contact Person (Optional)

• Full Name
• Relation
• Mobile No
• Email

Please tick (✓) The appropriate box if the student needs any/all the following services.

• Bus

  Yes No

  Pick Up Point

Any Particular disease(s)/illness(es)/allergy/ student is suffering from? If yes, Please give details.