Queen's Valley School
ON-LINE REGISTRATION FORM
(2012-2013)
(Online Registration is not Mandatory)
Please Note: Registration will be treated as incomplete and will be rejected if the Physical Registration Form along with the required necessary documents & Registration Fee of Rs. 25/- Cash are not received before 15:00 hrs, 16th January 2012.
*
Fields are mandatory
Student's Details
*
First Name
Middle Name
*
Last Name
*
Date of Birth
DD
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
-
MM
January
February
March
April
May
June
July
August
September
October
November
December
-
YYYY
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Date Of Birth (in words)
Place of Birth
Class Applying For
Pre-School
Pre-Primary
Other Classes
Other classes, specify
Father's Details
Mother's Details
*
First Name
First Name
Middle Name
Middle Name
*
Last Name
Last Name
*
Profession
Profession
*
Designation
Designation
*
Org./Company Name
Org./Company Name
*
Official Address
Official Address
*
Mobile No.
Mobile No.
Office Phone No.
Office Phone No.
Residence Phone No.
Residence Phone No.
*
Email Address
Email Address
*
Present Address
*
Permanent Address
*
Contact No.
*
Other Details [Please select the appropriate & attach proof (hard copy)]
General
OBC
SC
ST
Minority Community
Do you want to avail School Transport
Yes
No
(If yes from where)
Information on Criteria adopted bt the school:
Distance
of the school from the residence
0-03kms
03-05kms
05-10kms
Beyond 10 kms
Points: 40
Points: 30
Points: 20
Points: 10
Sibling-
Is a sibling of the student studying in this school?
If yes please give following details of the sibling & attach proof (Points 20)
Yes
No
Name
Adm No.
Class
Section
Wards of parents transferred to Delhi after July 2011
(Points 20)
Yes
No
Physically Challenged-
Is the child Physically Challenged
(Points 10)
Yes
No
Single Parent-
Are you a single parent (Points 10)
Yes
No
Please produce the original documents at the time of admission.
We hereby declare that information given above is true and authentic. We do understand that the admission of the child may be cancelled if any information is found to be false.
(Online Registration is not Mandatory)
Please Note: Registration will be treated as incomplete and will be rejected if the Physical Registration Form along with the required necessary documents & Registration Fee of Rs. 25/- Cash are not received before 15:00 hrs, 16th January 2012.
Important Documents to be attached with the Registration Form
The filled in applicatino form should contain the
Attested Photocopies
of the following documents:
a) Birth Certificate
b) Two proofs of Residence
c) One photograph each of child, mother and father or the guardian as the case may be.
d) Photocopies of proofs in support of school specific criteria