Online Registration (Other Than Nursery) Please Fill in Yellow Box. (FILL IN CAPITAL LETTERS) Student Photo Father Photo Mother Photo GENERAL INFORMATION I/We are considering enrolment in Grade/ Class Select KG I II III IV V VI VII VIII IX XI with effect from Have you ever applied for admission at any G.D. Goenka Schools earlier Select Yes No If YES, when? Academic year for which Class PERSONAL DATA OF STUDENT Surname First Name Middle Name Date of Birth In words (Age as on 31.03.2019 ) Sex Select Male Female Nationality Mother Tongue Permanent Address City Pin Code Country Mob# Home Tele# Mailing Address if different Pin Code Country Email Address HEALTH INFORMATION Allergy/ Chronic ailment if any Physical handicap/ disability if any Blood Group Any other health problem Does the child have any special needs? Select Yes No EDUCATIONAL BACKGROUND Name(s) of previous and present Schools(s) attended City State Country Has the child ever been Expelled/Rusticated/Not promoted to next class by any School? Select Yes No If YES, Please give details : Reason for leaving the School? PARENTS/ GUARDIANS INFORMATION Father's/Guardian's Details Mother's Details Relationship with Child Are parents living together Select Yes No Whether son/daughter of a single parent? Select Yes No PROFESSION / OCCUPATION Father's/Guardian's Profession/Occupation Off. Address (if , use two lines) Off.Tele.# Mob # E-mail Mother's/Guardian's Profession/Occupation Off. Address Off.Tele.# Mob # E-mail OTHER RELATIVES INFORMATION Real Brother; Sister 1. Name Age School attending/attended Real Brother; Sister 2. Name Age School attending/attended Relatives who are studying/have studied in the G. D. Goenka Schools Select Yes No Name Class Year of Joining Relationship REFERENCES Details of persons who can vouch for you not related you Name Designation Telephone Address City/ State Pin Code Name Designation Telephone Address City/ State Pin Code TRANSPORT School Bus Facility Select Yes No ADDITIONAL INFORMATION Aadhaar card(Father) Aadhaar card(Mother) Aadhaar card(Child) Aadhaar card(Guardian) DECLARATION / UNDER TAKING I Select father/mother of guardian of hereby declare that the information given above by me is correct to the best of my knowledge and belief. Admission of the child may be cancelled if any information is found to be false/incorrect. I also understand that the use of the School transport is optional and can be availed on payment of the prescribed charges and is subject to availability of a seat.