APPLICATION FORM FOR ADMISSION TO NURSERY / KG-1/ KG-2 Session: 2023 - 2024 INFORMATION IN BLOCK LETTERS ONLY :(Please fill the form legibly) Full Name of Child Date of Birth (In figures) Place of Birth (In Words) Age as on 01st April 2023 Gender: MaleFemale Student’s Aadhar No. : Blood Group: Student’s Family Samagra ID : Student’s Samagra ID : Religion : Caste : Category: SC/ST/OBC/General : Nationality : Father's Name : Mother's Name : ADDRESS : Present Residential Address : City : Pincode : State: : I.M.C. Zone NO. / Gram Panchayat: Ward No. : Native Residential Address : Phone No. : City : Pincode : State: : I.M.C. Zone NO. / Gram Panchayat: Ward No. : ACADEMIC : Name and class of sibling(s) (own brother / sister only) currently Studying in SICA School (if applicable) Branch: 5478SanghiAranyaNipania Name : Scholar No. Class : Section : Name and class of cousin(s) currently Studying in SICA School (if applicable) Branch: If more than one, please specify in a separate sheet. 5478SanghiAranyaNipania Name : Scholar No. Class : Section : DOCUMENTS TO BE SUBMITTED WITH FORM: THE FORM IN CAPITAL LETTERS ONLY. Required documents to be attached along with the form: Attested copy of birth certificate (copy+original to verify). Blood Group (from a Registered Pathology). Copy of SSMID / Family ID. Copy of Adhar Card (Parents and Child). [multifile* adharcard] Medical Fitness Certificate of Child. Caste Certificate (if applicable). Residence Proof (Electricity Bill / House Agreement / Voter ID / Aadhar Card. Photos of the Child, Father, Mother and Guardian [multifile* Allimages] Proof of Income Certificate / Latest Salary Certificate / Salary Slip. Note: As per CBSE rules, abbreviations in Child's Name, Father and Mother's Name is not allowed. Change in the details given in this form are not liable for alterations later. Details about Parents (All Entries are Compulsory): TITLE FATHER MOTHER CLOSE RELATIVE Name Qualification Occupation Designation Name of Organization Office Timings Phone Nos. / Mobile Secondery Phone Nos. / Mobile Mother Tongue Monthly Income Proof of Income Attached Email ID Aadhar No. Please upload Recent Passport Size Photograph Details About Guardians (All Entries are compulsory) TITLE Paternal Grandparents GUARDIAN 1 Maternal Grandparents GUARDIAN 2 Name Qualification Occupation Address Phone Nos. / Mobile Secondery Phone Nos. / Mobile Mother Tongue Monthly Income (Salary/Pension) Email ID Aadhar No. DECLARATION I declare that If the fee remains unpaid for more than a quarter from the due date, then the admission is liable to be terminated and the name of my child will be struck off from the rolls. If I withdraw my child before completion of the term for any reason whatsoever, I shall be liable to pay full fee for the whole term. I will not indulge in any sort of group (Social Media / Physical) I hereby declare that, I shall follow all the norms and regulations of the school. UNDERTAKING I / We hereby undertake to abide with all the rules and regulations of the school. Father's Signature Mother's Signature Guardian's Signature Guardian's Signature Put correct letter :- [honeypot Email]