Form No.

PN/
DC

ISSUE OF REGISTRATION FORM DOES NOT IMPLY ADMISSION AS SEATS ARE LIMITED.

(Please register the name of my son/daughter for admission in your school).

Information Relating to the Child
1.
Class to which Admission is sought (Pre Nursery/Day Care)......................................................
2.

Child's Name (in full and block letters).....................................................................................

3.

Date of Birth (in words and figures)

Age on last birthday...................................Years..........................

4.

Age as on 30th September. (Year in which admission is sought) ..Years........Months......Days

5.

Nationality of Child....................................................................................................................
Mother Tongue...........................................................................................................................
Religion.......................................................................................................................................

6.

Address of child
a)
Home Town.................................................................State...........................................
Nearest Railway Station/Airport....................................................................................
b)

Address:(Permanent)......................................................................................................
....................................................................................Phone No. ..................................

c)

Address:(Present)...........................................................................................................
..................................................................................Phone No. ....................................

Information Relating to the Family

1.
Father's Name (Block Letters)........................................................................ ...........................
Occupation....................................................................Designation .........................................
Name of the Organisation/ Company......................................................... ...............................
Office Address............................................................................................................................
Academic Qualification..
Phone (Office).......................................................Mobile No....................................................
Email........................................................................................................ .................................

2.

Mother's Name (Block Letters)........................................................................ .......................

Occupation...............................................................................Designation ..............................
Name of the Organisation/ Company......................................................... ...............................
Office Address...........................................................................................................................
Academic Qualification.............................................................................................................
Phone (Office).......................................................Mobile No...................................................
Email........................................................................................................ .................................

3.

Legal Guardian's Name (Block Letters)..................................................................................

Occupation.........................................................................................Designation ....................
Name of the Organisation/ Company......................................................... ...............................
Office Address...........................................................................................................................
Academic Qualification.............................................................................................................
Phone (Office).......................................................Mobile No...................................................
Email........................................................................................................ .................................

4.

Kindly study the fees structure carefully and mark the preferred option
Annually

Quarterly

Checklist of documents to be submitted

1.

 Attested municipal birth certificate

2.

 Immunization record of child (to be submitted along with admission form)

3.
4.

 Photocopy of Proof of Residence (ration card / voter identity card / residence lease deed /
any other)
 Registration Fee of Rs. 1000/- (in cash or DD, favouring Apple Blossom, Gurgaon)

5.

 Certificate of disability (if applicable)

Signature..................................
Name in Full (block letter)
...............................................................
...............................................................
Address..................................................
...............................................................
Date

...............................................................

Place................

...............................................

DECLARATION:i).

I fully understand that registration is not a guarantee for admission. Admission is granted only
when there is an existing vacancy.

ii).

I understand that the Registration Fee of Rs. 1000/- is non-refundable.

iii).

I have made careful note of various details regarding the payment of school fees. I have made
satisfactory arrangements for the remittance of school fees within due dates without waiting for
reminder from the school. I will pay the school fee through crossed cheques/drafts in favour of
Apple Blossom, Sushant Lok.

iv).

I understand that request for cancellation of admission will be considered only if given in
writing on the prescribed from (available on the school website/school reception).

v).

I hereby certify that the date of birth & spelling of the name of my child/ward given in this
form are correct and I shall not make a request for any change.

vi).

I hereby certify that in case I do not claim the Caution Money within a period of one year of
cancellation of admission. I will have to forfeit my right over the refund of this amount.

vii).

I understand that rendering false or misleading information or withholding correct information

may disqualify or lead to cancellation of admission/continuation of the child in this school.

viii).

Having carefully read the rules, regulation and procedures laid down in the school prospectus
and being desirous of having any child/ward admitted in Apple Blossom, I hereby agree to
abide by these rules in all respects. I understand that the decision of the Management shall be
final and binding.

ix).

I hereby certify that I shall follow all the rules, regulations & procedures laid down by the
school from time to time.

x).

I understand that the fees may increase as per the decision of the management.

xi)

I certify that I am a bonafide parent/guardian of the child and that information furnished in this
form is true.

xii).

I hereby attest my signature to confirm the above declarations.

Date

Signature..

Place

Name in full (Block Letters)..

Address..

For office use only

Passport size photographs (Two copies) received ..........................
Immunization record submitted/Not Submitted .....................................
Other documents (if any) ..........................
Admission No. Pre Nursery/Day Care........................
Apple Blossom(Pre Nursery)
Admission Fee

Rs.

Admission Clerk

Security Deposit
Annual
Maintenance
Quarterly Tuition Fee
Bus Fee

Rs.

Date ...

Rs. .
Rs..
Rs..

Florets(Day care)

(8:30 AM- 6:00 PM)

Admission Fee

Rs.

Admission Clerk

Security Deposit
Annual
Maintenance
Quarterly Tuition Fee
Bus Fee

Rs.

Date ...

Rs. .
Rs..
Rs

Florets(Day care)

(1:00 PM- 6:00 PM)

Admission Fee

Rs.

Admission Clerk

Security Deposit
Annual
Maintenance
Quarterly Tuition Fee
Bus Fee

Rs.

Date ...

Rs. .
Rs..
Rs

Total Amount Received Rs. .

Receipt No.

Date

Signature of Accountant

Class Rep/Manager-Admissions

Date.

Approved/Not Approved

Principals Signature