BP MEMORIAL SCHOOL
SANYASIBAGH, MALIHABAD, LUCKNOW
Pin Code: 226101
Affiliated by U.P. Gov.
Photograph of the Student
Photograph of the Father
Photograph of the Mother
information about Student
Admission
Old
New
Name of the student(In block letter)
First Name....................................................
Middle Name...................................................
Last Name......................................................
Gender...........................................................
Date Of Birth......................................................
Aadhar No...........................................................
Age as on 1st April of the Academic Year: Day Month Year
Day...............................................
Month...............................................
Year................................................
Father's Name...............................................................................................
Mother's Name...............................................................................................
Contact No...................................
Alternate No.....................................
Email Id..........................................................................................................
CategoryGen
OBC
SC/ST
Cast Category.................................................................................................
Sibling Status(if any)...........................................................................................................................................................................................
Present Address:-
Villege................................................
Post...................................................
Tahseel...................................................................
District...................................................
State...................................................
Pin Code.................................................................
Nationality.....................................................................................................
Religion...............................................................................................................
Correspondence Address:-
Villege................................................
Post...................................................
Tahseel...................................................................
District...................................................
State...................................................
Pin Code.................................................................
Previous Academic Record
Name of the last attended School.....................................................................................................................................................................................................
Address..............................................................................................................................................................................................................................................
class.............................
Grade.............................
Other Deatails
Father's Educational Qualification.....................
Father's Occupation.............................................
Father's Aadhar No.............................................
Mother's Educational Qualification.....................
Mother's Occupation.............................................
Mother's Aadhar No.............................................
For Transport Requiremnet
Name of the Student .................................................................................................................
Residental address ..........................................................................................................................................................................

.............................................................................................................................................................................................................
Contact No.......................................................
(Please keep the school informed of the changes in the address and contact Numbers)
Declaration of the Father/Mother/Guardian
I hareby certify that the information given in the registration from by me is accurate and complete.I understand and agree that representation or omission of facts will lead to denial and cancellation of admission or expulsion. I have read and hereby agree to the Terms and Conditions enclosed with the registration form
Date:____/____/______
Signature of the Father/Mother/Guardian
Note: Colored Photo-3, Aadhar Card Photocopy-2, Marksheet Photocopy-2, Transfer Certificate- Original.
application received for
For Office Use only
Application No................................
Name of the Student ...........................................................................
Father's Name ...............................................................................................
Application received for .................................... Class.
Residental address ......................................................................................................................................................................................................

Contact No.......................................................
Date:..................................
Signature ................................................