For Office use only RISHI VALLEY SCHOOL (Krishnamurti Foundation India) REGISTRATION AND APPLICATION FORM FOR ACADEMIC YEAR 2021-22 Phone: 08571 – 280622/ 280582/ 280086 Mobile: 9493547322/ 9493547822/ 7893644497/ 7893644717 Email : [email protected] PLEASE ENSURE THE FOLLOWING ARE ATTACHED: (1) Photo (2) The most recent year-end school report available as of now (*) (3) Proof of date of birth (4) Relevant pages of Passport and visa details where applicable (5) Payment details Incomplete forms will not be considered. This form should be filled in and should reach the Principal, Rishi Valley School, Rishi Valley 517 352, Chittoor District, Andhra Pradesh, not later than 15th December 2020. Submission of this form does not guarantee an interview call. (*) You may be asked to submit the latest report (from current year) if selected for the interview. 1. (a) Full Name (IN CAPITALS): (As per official records) (b) Male/ Female : Male / Female Please affix a recently 2. Date of Birth (dd/mm/yyyy): taken Passport size photograph of the child with white 3. Place of birth : background 4 Citizenship of the child : 5. Mother tongue : Can Speak Read Write 6. Other languages known : 7. Languages commonly spoken at home: 8. The language you wish your child to learn as the : (i) Second Language: Hindi / Telugu (ii) Third Language (up to Class 8 only): Telugu / Hindi (The third language should be different from the second language) (iii) Previous exposure to Hindi(H)/ Telugu(T)/ Both(B): Can Speak Read Write (Fill the boxes with H/ T/ B) 1 9. a) Class for which you are applying: b) State the completed age as of 1 st June 2021: ___years ___months (completed) *The regular entry points are standards 4,6,7 and 11 only. Admissions to classes 5, 8 and 9 are against vacancies created by withdrawals. 10. Have you applied to Rishi Valley for this child’s admission earlier? If yes, please give the details: Class(es) and academic year(s) for which you applied and registration number(s): 11. Particulars of previous schooling: Please attach a copy of the latest available school report and mark sheet. Date of Date of Name of the School Place Standard Joining Leaving 12. Brothers and sisters of the applicant: Name Age M/ F School / College Standard 13. If any sibling(s) are studying in Rishi Valley School, please mention the details (Name & Class): 14. If a sibling is also applying for admission into Rishi Valley School, please mention the child’s name and class: 15. Names of near relatives, if any, who are studying or have studied in Rishi Valley School, with dates (please state their relationship to you). (This is other than stated above in Point 13): 16. Passport details (only for Foreign Citizen): 2 17. Visa/ Resident permit details (where applicable): (Foreign Citizens should have a Student Visa/ PIO Card/ OCI Card) (Please submit photocopies of the relevant pages) 18. Health / Food habits: Note that if your child gets admission, this information will help us to support your child in a better manner. Please give complete and accurate information. a) Is the child a vegetarian Non-vegetarian Vegan b) Please rate your child’s eating habits. (Tick one) (Please consider items like vegetables, leafy greens which are essential part of Rishi Valley menu) Good Fair Poor c) Is there a history of childhood illnesses including physiological, psychological/mental: Yes No If yes, please give details. d) Present condition: e) Dates of preventive inoculations: f) Physical weaknesses/allergy, if any, that require special attention: g) Past history: Have you noticed any (i) Inter personal problematic behaviour: Yes No (ii) Learning difficulties: Yes No If yes, please give details. h) Any other issues in which the child might need help in a residential environment: (like bed-wetting, sleep-walking, etc.) 3 19. A description of the child: a) Temperament and personality: b) Aptitudes and interests: c) Academic profile: 20. In what way has Rishi Valley School come to your attention? What are your reasons for seeking admission in Rishi Valley School? 21. The aim of education, according to Shri J Krishnamurti, is to bring about a good human being. What else would you consider to be desirable objectives for a good school? 4 22. Students coming to Rishi Valley School for the first time face many new demands – having to look after themselves and their belongings, managing their daily routine as well as studies, living cooperatively in a group, foregoing television, computer-based entertainment, electronic gadgets; eating simple vegetarian food etc. List some of the ways in which your child has been prepared for living in such a residential school environment. 23. Given the non-competitive structure of Rishi Valley School (no formal exams until class 9, no ranking, no comparison of students) how do you see your child meeting the challenges of today's highly competition-driven world, including the need to meet the high cut-offs for admission into college? Kindly note: Over the years we have seen that not all children are able to settle and flourish here. This can happen for a variety of reasons. In the event that we find a child unable to adjust to the residential and learning environment at Rishi Valley, even after more than a term here, including for reasons not declared in 18 above regarding health and past history; the school reserves the right to recommend that the child be withdrawn. 5 24. Information about parents / guardians: Please ensure that each parent (or guardian in case parents are no more), who is individually or jointly responsible for the student financially or otherwise, fills up the information in the following pages. a) To be filled by the father (or guardian if the parents are no more) i) Name: ii) Relationship to the student: Father / Guardian: iii) Father’s / Guardian’s native place & State: iv) Educational / Professional Qualifications: Details of Colleges / Universities attended: v) Name & Address of Company / Business / Organisation (Please specify as applicable): vi) Please elaborate on the nature of your work and responsibilities. vii) Are you a Non-Resident Indian? If so give details. viii) Details of any connection either with the Krishnamurti Foundation or any of the schools run by the Foundation: ix) Any other details you consider important, but are not covered above: 6 b) To be filled by the mother (or second guardian if the parents are no more) i) Name: ii) Relationship to the student: Mother / Guardian: iii) Mother’s / Guardian’s native place & State: iv) Educational / Professional Qualifications: Details of Colleges / Universities attended: v) Name & Address of Company / Business / Organisation (Please specify as applicable): vi) Please elaborate on the nature of your work and responsibilities. vii) Are you a Non-Resident Indian? If so give details. viii) Details of any connection either with the Krishnamurti Foundation or any of the schools run by the Foundation: ix) Any other details you consider important, but are not covered above: 7 c) Annual family income – Before tax Annual income of Father/ First guardian : Annual income of Mother/ Second guardian : kindly note: Partial fee concessions are available for deserving students based on merit, means and availability of funds with the school. If you wish to avail concession, please submit a letter to this effect along with the application. d) If the guardian of the child is someone other than the father or mother state the reasons and background. e) If the parents are separated or divorced, please indicate clearly the legal status of the child in terms of custody and access to parents and the arrangements between the parents regarding the visitation rights or any other rights in conformity with the orders of the legal authority and school rules. In such cases (those in which one of the parents has visitation rights or any other rights and the other parent has custody) both the parents should sign the application form. (This application is liable to be rejected and the admission is liable to be cancelled at any stage in case of any misstatement.) Please submit a copy of the supporting documents. f) If the parents are separated or divorced, please indicate the person responsible for payment of fees. g) Is the child adopted? Please give necessary details like age of the child when adopted etc., h) If adopted, does the child know it? 8 25. Addresses for communication a) Father / guardian Mother / guardian Address: Address: Mobile: Mobile: Phone (Res): Phone (Res): Phone (Off): Phone (Off): E-mail: E-mail: b) Please note that if both the parents/guardians are abroad, it is mandatory to have a local guardian. Please state the address of local guardian to be contacted in case of emergency, if both parents/guardians are abroad. Address: Mobile: Phone (Res): Phone (Off): E-mail: c) Mailing address (for all correspondence, including term-end reports): Address: Mobile: Phone (Res): Phone (Off): E-mail: Name & Signature of the father / guardian: Name & Signature of the mother / guardian: Date: Place: September 2020 9 .