Smt. S. R. Patel English Medium School
College Road, Dakor, Taluka- Thasra, Dist.-Kheda, State-Gujarat, PIN-388225
Phone: 9638202069, 02699-245665, Website: www.pulhashram.org, E-mail: pulhashram.dakor@yahoo.com
APPLICATION FOR ADMISSION
STUDENT's INFORMATION: (Please use BLOCK LETTERS and do not leave any coulumn blank which is Compulsory *)
Student's Name:
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Nick Name:
Date of Birth:
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Birth Place:
Belongs to:
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SC
ST
OBC
General
Other
Applying for Grade/Standard:
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Age:
Nationality:
Mother Tongue:
Religion:
Name and Address of the previous school attended:
Address for Correspondence:
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Mobile/Telephone Number:
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Student's E-mail:
Student's Passport No:
FATHER's INFORMATION:
Father's Name:
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Occupation/Position:
Qualification:
Mobile Number:
Office/Business Address:
E-mail:
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MOTHER's INFORMATION:
Mother's Name:
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Occupation/Position:
Qualification:
Mobile Number:
Office/Business Address:
E-mail:
