KENDRIYA VIDYALAYA RANGE HILLS ESTATE

Registration for class I and above

                   S.No                                       2012
Registration for class *
Shift  

1.  Name of child in full (in Capital letters)*

Sex  Male/Female*    

2.  Date of Birth   Day*       Month*      Year*

Date of Birth in In words *

Age at the time of admission     Years*  Months* Days*
3. Blood Group of the child* 
4 Do you belong to Gen./SC/ST/OBC/EWS/Disabled/S.G. Child ? *      If yes, attach relevant certificate

Gen/SC/ST/ST/OBC/EWS      

Disabled Single Girl Child Staff Ward      

5.Details of Mother/ Father

 Mother Father

i. Name (in Capital letters)
ii. Nationality
iii. Occupation
iv.Name of Office and full address with telephone numbers
v. Full residential address with  telephone numbers (with proof)
vi. Distance of residence from KV* Km. Km
vii. Permanent Address
viii. Basic Pay
ix. No.of transfers during last 7 years as on 31-3-2012 of the year*
x. Category to which the Parent belong  to Defence /Central Govt./Autonomous body & other
xi. Mobile  

  

 I certify that the above entries are true to the best of my knowledge.

 Signature of Parent

Full Name*

 Date:

 

Note:   1.   Proof of residence shall have to be produced by all applicants.

        * 2. A self declaration from the parent for distance may also be accepted by furnishing an undertaking to this effect.