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 31.03.2018 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.

UTR No. ______Date ______

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.)

DISTANCE CHART Pre Nursery Admission (2018-2019) Area Code Nerul CBD-Belapur

Nerul (W) - M Sec 52, Sec 54, Sec 56, Sec 58A

Nerul (W) CBD Sec-32 N Sec 50 (New/Old)

Nerul - O Sec 46, Sec 46A, Sec 44, Sec 44A

Nerul CBD Sec 15A P Sec 48, Sec 48A

Nerul (W) CBD Sec 20, Sec 15 A Sec 38, Sec 42A, Sec 42 Nerul (W) CBD Sec 19, Sec 21, Sec 22 Sec 34, Sec 36, Sec 32, Sec 30, Sec 40 B Rati Bunder Karave Gaon, Nerul (E) Sec 25, Sec27 CBD Sec 24, Sec 25, Sec 23, Sec 26, Sec 27, Sec Nerul (W) Sec 26, Sec 28 28, Sec 29, Sec 11, Sec 14 C Nerul (E) Sec 19A, Sec 21, Sec 23 Diwale Village Nerul (W) Sec 18, Nerul (E) Sec 19, Nerul CBD Sec 30, Sec 31, Sec 10 D Stn. RBI CGO Nerul (W) Sec-14, Sec 16, Sec 18A, Sec 6, CBD Sec 9, Sec 9N, Sec 1, Sec 1A, Sec 2, Sec 3, Sec 8, Sec 24, Sec 12, Sec 10 Sec 4, Sec 5, Sec 6, Sec 12, Sec 13, X Sarsole Village, Sec 20, Sec 22 Ulwe, Kombad Bhuje, MOHA, Ambuja Cement Nerul (E) Sec 13, Sec 15, Sec 17 Nerul (W) Sec 2, Sec 4,Shiravane village CBD Sec 8A, Sec 8B, Artist Village, Ulwe Sec 2, Nerul (E) Sec1, Sec 3, Sec 5, Sec 7, Sec 9, Y Sec 3, Gaonthan Sonkhar Sec 11

Sanpada and Juinagar Sec 22, Sec 23, Sec 20, Sec 19, Sec 18, Sec CBD RBI, Bharti Vidyapeeth, Ulwe Sec 23, Sec 16A, Sec 16, Sec 14, Sec 13, Sec 1, Sec 2, S 20, Sec 5, Sec 3, Sec 19A, Sec 19 Sec 3, Sec 7, Sec 6, Sec 10, Sec 11, Sec 15, Sec 4, Sec 9, Sec 17

Vashi - Sec 1, Sec 2, Sec 3, Sec 4, Sec 6, Sec Sec 1, Sec 2, Sec 4, Sec 5, Sec 6, Sec 7, 7, Sec 8, Sec 9, Sec 10, Sec 10A, Sec 11, Sec Sec 8, Sec 9, Sec 10,Ulwe, Wahal Village Sec T 12, Sec 14, Sec 15, Sec 16, Sec 29, Sec 30, 19B, Sec 18 Sec 17 Sec 19 to Sec 27, Sec 28 Kharghar (Before Central Park) Koperkharine Sec 11, Sec 14, Sec 18, Sec 8, U Ulwe Sec 9, Sec 8, Sec 17, Sec 16 Sec 13, Sec 9, Sec 15

Kharghar (Sectors after central park) V Koperkhairne Sec 1 Rest of Navi Mumbai

SCHOOL BANK ACCOUNT DETAILS FOR REGISTRATION (PRE-NUR 2018-19)

SCHOOL ACCOUNT NAME DELHI PUBLIC SCHOOL - CURRENT A/C

ORIENTAL BANK OF COMMERCE BANK ACCOUNT NAME NERUL STATION COMPLEX

BANK IFSC CODE ORBC0100892

BANK ACCOUNT NO 08921010001570

REGISTRATION AMOUNT Rs.900/-

Duly filled in downloaded form along with payment confirmation (UTR acknowledgement) print out shall be submitted from 13/12/2017 to 22/12/2017 from 10:00am - 1.00pm (on working days only)