DELHI PUBLIC SCHOOL CBSE Affiliation No. :1130068

Registration Form

Reg.no. ______Academic Session 20 ___ -- ___ Photograph (To be filled by the office)

Fill the details in block letters

1. Pupil’s Name:______(as per Birth Certificate / Transfer Certificate) 2. Date of Birth: DD MM YYYY Gender: M F

3. Age as on 31.03. 2 0 Yrs Months Days Class :______

4. Academic Record (Previous year): if applicable

Class Year School Board Overall grade/ Percentage

5. Particulars of the Parent: Parents’ Details Father Mother Name

Academic Qualifications Occupation / Profession Full Designation Office Address

Tel (O) Mobile E-mail Monthly Income (Rs.) Current Residential Address.

Permanent Residential Address Tel (R ) / Mobile

DPS Alumni : (Father) Year of passing ______Branch ______

(Mother) Year of passing ______Branch ______

Sibling (Studying in DPS, Navi Mumbai): Name:______Class/ Section: ______

------Acknowledgment Slip

Name of the Child Admission to Class

Registration No Date Signature (for Office Use):

Declaration:

1. I understand that the REGISTRATION FEE is non-refundable. I also fully understand that

REGISTRATION is not a guarantee for admission. Admission is granted as per the school norms.

2. I hereby certify that the date of birth and spelling of the name of my child /ward given in this form

are correct to the best of my knowledge. And I shall not make any request for any CHANGE.

3. I understand that rendering false or misleading information or withholding correct information shall

lead to cancellation of child’s admission at the school.

4. I hereby certify that my child / ward and myself shall follow all the rules, regulations and procedures

given in the school almanac and any other rules etc. as laid down by the school from time to time.

DD No ______Date ______Bank on which drawn______

Date: ______

Place: ______

Signature of parent / guardian

DELHI PUBLIC SCHOOL NAVI MUMBAI Palm Beach Marg, Nerul, Navi Mumbai-400706 Tel: 27526632, 27526928 Tele fax: 27526894 Website: dpsnavimumbai.org

DELHI PUBLIC SCHOOL

Nerul Navi Mumbai Name of the Child :______Reg.No.______

Sr. Specification No.

For Parents For the School

1 Area Code (Neighbourhood)

2 Siblings (Real Class/Sec Name of the brother/sister) student Studying in DPS, Navi Mumbai

Alumni : (DPS) 3

Father Yes /No

Mother Yes/No

Child with Minimum 4. Special Needs (only Yes/No orthopaedically challenged (with up to 25% disability) who can be mainstreamed within the existing facilities.)

Area NERUL CBD Code Nerul (W)- Sec 54, Sec 56, Sec 46A, CBD - Sec 15A, Sec 32 Sec 50(W), Sec 52A, Sec 58A, Sec 44A, P  Sec 44, Sec 46, Sec – 48, Sec – 48A

Nerul –Sec 38, Sec 42A, Sec 42 CBD - Sec 20, Sec 15 Q Nerul (W)–Sec 34, Sec 36, Sec 32, Sec CBD - Sec 19, Sec 21/22 R 30, Sec 40, Karave Gaon - Reti Bunder Nerul (E)–Sec 25, Sec 27 Nerul (W)– Sec 26, Sec 28 CBD - Sec 24/25, Sec 23, Sec 26/27, Sec S Nerul (E)–Sec 23, Sec 21, Sec 19A 28, Sec 29, Sec 11, Sec 14 Diwale Village. Nerul (W)– Sec 18, CBD - Sec 30, Sec 31, Sec 10,RBI CGO A Nerul (E)– Sec 19, Nerul Stn. Nerul (W)– Sec 14, Sec 16, Sec 18A, CBD - Sec 9, Sec 9N, Sec 1, Sec 1A, Sec Sec 6, Sec 8, Sec 24, Sec 12, Sec 10 2, Sec 3, Sec 4, Sec 5, Sec 6, Sec 12, Sec B Sarsole Village, Sec – 20, 22 13. Nerul (E)– Sec 17, Sec 15, Sec 13 Ulve , Kombad Bhuje, Moha, Ambuja Cement Nerul (W)– Sec 2, Sec 4, Shiravane CBD - Sec 8A, Sec 8B, Artist Village. Village Ulve Sec- 2, 3, Gaonthan Sonkhar. C Nerul (E)– Sec 1, Sec 3, Sec 5, Sec 7, Sec 9, Sec 11 Sanapada & Jui Nagar- Sec 25, Sec CBD - RBI, Bharti Vidyapeeth, 24, Sec 22, Sec 23, Sec 20, Sec 19, Sec Ulve- Sec- 23, 20, 5, 3, 19A, 19 D 18, Sec 16A, Sec 16, Sec 14, Sec 13, Sec 1, Sec 2, Sec 3, Sec 7, Sec 6, Sec 10, Sec 11,15,4, 9, 17 – Sec 1, Sec 2, Sec 3, Sec 4, Sec - Sec 1,Sec 2, Sec 4,Sec 5, Sec G 6, Sec 7, Sec 8, Sec 9, Sec 10,Sec 10A, 6, Sec 7, Sec 8, Sec 9,10, Ulve, Whal Sec 11, Sec 12, Sec 14, Sec 15, Sec 16, Village-19B, 18 Sec 29, 30, 17. Vashi –Sec 19 to 27, Sec 28 Kharghar (Before the Central Park) H Koperkhairne - Sec 11, Sec 14, Sec 18, Ulve-Sec – 9, 8, 17, 16 Sec 8, Sec 13, Sec 9, 15

Rest of Navi Mumbai Kopherkhairne Sec - 1

K Kharghar (Sectors after the Central Park)