SAMSKAR INTERNATIONAL SCHOOL

APPLICATION FOR ADMISSION

For the Academic Year: *	Admission to Class: *	Photo: * Affix recent Colour Passport Size Photo (Only jpg or jpeg)
Board: *	I-Language: *
II-Language: *	Type of Admission: *

Personal Information

Parent Information: *

Additional Information

Identification marks (as per memo T.C.): ***

Contact Information: *

Communication Address: **		Permanent Address: ** Click Here Same as Communication Address
D.No:		D.No:
Street Name:		Street Name:
Village/Town:		Village/Town:
Mandal:		Mandal:
District:		District:
Pin Code:		Pin Code:
Cell:		Cell:
Whatsapp:		Whatsapp:
Email ID:		Email ID:

Details of Siblings studying in Educational Institutions: **

Name of the student:	Class	Name of the Institution	Place

Details of Previous Schooling: **

Name & Locations of Schools:	Period of Study	Grade(s)	Board	Medium	Reasons for changing

Health Information: *

Any Food Allergy (if known): **
Any Drug Allergy: **
Any other medical history that needs to be informed to the School:: * Asthma Migraine Sinusitis Bleeding Disorders None
Past Medical History: *

Native Place: *

Does your child require School Transport?: *

Yes No

*	Must be fill this field
**	Some field is partially filled
***	Identification marks One is mandatory

Admission