ST. JOHN’S VISITATION PUBLIC SCHOOLMUPPATHADAM, ALUVA, 683110
CBSE AFFILIATION NO: 931198
Ph: 0484 2607255, 9061364002
Email: visitationsch@gmail.com
www.stjohnsvisitationschool.com
Photo

APPLICATION FOR ADMISSION TO ..............
1. Full Name of the Pupil (Capital Letters) :.............................................................................................
2. Expansion of initials: .............................................................................................

3. Sex: MaleFemale

4.

Age: years

Month5.

Date of Birth:

Date:

Month :

Year:

( as given in the birth certificateIn Words: ...............................................................................................

6. Religion & Caste: ...............................................................................................

7. Nationality: ................................................................................................

8. Name of the Father: ...............................................................................................

9. Occupation: ...............................................................................................
: Phone(Office)...................................................................
Mob:.....................................................................................

10. Name of Mother: ................................................................................................
: Phone:..................................................................................

11. Occupation: ................................................................................................

12. Name of Brothers/Sisters studying in the school :.................................................................................
Class, Division:....................................................................................

13. Annual income of the Parent: ...................................................................................

14. Local Address for communication:.....................................................................................
:.....................................................................................
Pin code ..................................................................
: Phone( Resi)..........................................................

15. Permanent Address:.....................................................................................
:.....................................................................................
:.....................................................................................
:Pin code...................................................................

16. School transport facility needed

: Yes

No

17. If yes- nearest boarding point:......................................................................................

Place : ............................................................

Signature of the Father .......................................

Date :.............................................................

Signature of the Mother .......................................

For Office Use Only
Verified the copy of the birth certificate against OriginalName, Designation, date and signature of the person verified the document
1. Class to which admitted:.....................................................

2. Admission Number:.....................................................

3. Date of Admission:......................................................

Signature of the Principal: