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(Dr.K.M. Cherian Educational Society)

Mathur Road, Kalapet,
Pondicherry - 605 014.
Phone:0413-2655355,2655353 FAX:0413-2655354
Website:www.lecoleinternationale.edu.in

Date of Issue:

Application No:

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FOR OFFICE USE ONLY


Selected/Not Selected:

House:

Admission No:.............................

Admission Date:...........................

Fee Reciept No:...........................



Signature of Principal

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APPLICATION FOR ADMISSION


Class:


Section:

Photo of the Student






    

Personal Data : Student

Full name of student: *
Class of Joining: *
Date of Birth: * Sex: Male Female *
Age at time of applying: * Blood Group:
Place of Birth:
City/Town:
* State/District: *
Country: * Area: Rural Urban *
Nationality: *
Native Place: *
Religion Christian Muslim Hindu Jain Others *
 
Community: FC BC MBC SC/ST OBC/OC/GEN Minority/Majority Others *
Students Aadhar No:
Mothertongue: *
Second Language Proposed to be taken: Third Language Proposed to be taken:
Student's General Intrests & Strength:
Preferred Extracurricular Activity:
Does the child have any Physical Disablities?: Yes No
If Yes ,Please specify:
Does the child have any special learning Disablity?: Yes No
If Yes ,Please Explain:
Name and address of the School last studied:
Class in which the Student last studied:
Reason for leaving the previous school:
Name the siblings who are currently studying at The Study:
Name1: Class:
Name2: Class:
Transport required: Yes No *
Identification Mark1:
Identification Mark2:

Personal Data : Family

Only Child: Yes No
Father: *Mother: *
Full Name of Father: Full Name of Mother:
Occupation: Occupation:
Qualification: Qualification:
Annual Income: Annual Income:
Official Address: Official Address:
Tel No: Tel No:
Mobile: Mobile:
Email: Email:
Address
Tel:
Contact & SMS Mobile:
Email:
Parents Aadhar No:
Family: Joint Nuclear *

Name and address of legal guardian[if any]

Guardian:
Name:
Address:
Relation: Occupation:
Tel: Mobile:
Email:
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