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Application No: SSFC20220051 Student Name: Corina Corina Koehler

Child Information

Student’s Name (In Block Letters)

Gender

Male Female

Blood Group

Session

Standard in which applicant seeks admission

Shift

Birth Date

Age

Years

Birth Country

Birth State

Birth City

Area

PinCode

Address

Student Photo

17427502366445827259041645045868.jpg

Phone No (R)

Mobile No (To get SMS)

Approximate distance from Satellite school

Primary Email Id

Name as Birth Certificate

Dise Number

Mother Tongue

Religion

Caste

Student Aadhar No

Country

State

City

Name of the Previous School attended

Previous School Board

Proof of Previous School Attended

PROOF OF SCHOOL.pdf

Birth certificate

17427507194587901142449439710548.jpg

Proof of Residence

Passport and Visa_New.pdf

Siblings Information

In case of no sibling click here

Relation Type

Brother Sister

Full Name

School

Class

SID

Do you want admission of your other child in Satellite School?

Yes No

Proof of Sibling (ID Card / Fee Receipt)

Has the child suffered any major injury in accident?

Yes No

If yes, give details.

What major illness has the child had? Are there any after effects?

Does the child fall ill often? State the nature of illness.