Please fill the required feildsDownload form here If you want to download this form,please click on the link Application for AdmissionName of Student ( in English) : *( in Malayalam) : *UID : *Gender : *MaleFemaleNationality : *Profile photo : II. Parent DetailsName of Mother ( in English) : *( in Malayalam) : *Name of Father ( in English) : *( in Malayalam) : *Guardian : *FatherMotherOtherIf Other ( specify Relation) : Name of Guardian : Occupation of Parent/Guardian : Annual Income (Rs) : Whether : APLBPL III. Address DetailsHouse Name : Place/Street : State : Revenue Dist : Taluk: Whether : MunicipalityGramaPanchayathCorporationDistrict Panchayath Block Panchayath Name of Local Body : Post Office : Phone Number : *Student E-mail ID : * IV. Previous School DetailsT.C N0 : Date: Date of Admission : Date of Leaving : School Previously Attended : Instruction of Medium : MalayalamEnglishTamilKannadaClass : Division : First Language paper I : MalayalamEnglishHindiIf other (specify): Second Language : MalayalamEnglishHindiIf other (specify): V. Additional DetailsDate of Birth : Place of Birth: Religion : HinduChristianMuslimOtherIf Other (specify) : Category : GeneralSCSTOBCOECCaste : Vaccination DetailsVaccinated : YesNoDate of Vaccination: Blood group: VI. Current DetailsWhether CWSN : Yes (CWSN-Children with Special Needs)NoIf ‘Yes’ specify : Blindness (40% or above disability)Low vision (20%-39% or above disability)Leprosy CuredHearing Impaired (40%or above disability)Loco Motor DisabilityMRMental illnessAutismCerebral PalsySpeech ImpairmentOthersIf Learning Disability : LD (Dyslexic)LD (Dysgraphia)LD (Dyscalculia)If Other (specify) : VII. Two Identification MarksIdentification Mark No 1 : Identification Mark No 2 : VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank:
