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SACRED HEART KINDER GARTEN

JAGADHRI-135003

Owned by Pushpadham Province - Reg. No. ER683/99

Application Form for Admission to NURSERY 2019-20
(Read the Instruction in the prospectus before filling up the form)

Reg. No. SHKG2231

Name of the Candidate Suvesha

Date of Birth 13,May 2015

Child's Photo
Father's Name Mr. GAURAV GARG

Mother's Name Mrs. RICHA GARG Father's Signature Mother's Signature

Residential 1867 CIVIL LINES

Address JAGADHRI HARYANA
Locality Code
Pin Code : No
1
Ph.No. : 9466636920 Alternate No.: 9355144880 [A]
Email Id : VPSK1975@GMAIL.COM

Sibling Real
Yes
Brother/sister only

2 if sibling in the N/A, Class : N/A

Parent school,
Give details of
sibling N/A, Class : N/A

School Alumni Father : No Mother : No

3 (A) Father Class : , Year :

(B) Mother Class : , Year :

Child with Special

Need as detailed in
Prospectus.
4 No
[Enclose
authenticated
documents]

5 Gender Female

6 Socially No
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Disadvantaged
Section

Christian
7 No
Minorities

Educational
Qualification

Post Gradute Degree and

8 (A) Father MTECH
Above

Gradute/All Post Gradute

(B) Mother BDS
Diploma Holders)

Occupation : BUS

Designation :

9 Parents Occupation (Father) Annual Income : 400000

Organisation Add. : VED PRAKASH

AND SONS 662 GANDHI MARG
JAGADHRI HARYANA

Occupation : DOC

Designation :

10 (Mother) Annual Income : 400000

Organisation Add. : VED PRAKASH

AND SONS 663 GANDHI MARG
JAGADHRI HARYANA

11 Student lives with Both Parents

CERTIFICATE FROM THE PARENT

I/We hereby certify that we have gone through the prospectus and I/We agree with the same. I/we hereby certify
that the above information provided by me/us is correct and I/we understand that if the information is found to
be incorrect or false, the ward shall be automatically debarred from selection/admission process without any
correspondence in this regard. I/we also understand that the application/short listing does not guarantee
admission to my word. I/we accept the process of admission undertaken by schooland I/we will abide by the
decision taken by the school authorities. Once the result displayed, the queries related to admission will not be
entertained.

Signature of the Mother Signature of the Father

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Date:_____________

Note:Verification of documents and Interactive session on 29,Dec 2018 at 10:00 AM

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