JEEWAN INTERNATIONAL SCHOOL
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STUDENT REGISTRATION FORM
(All "
*
" marked fields are MANDATORY, mention "N.A." if not applicable.)
Sibling Detail (only real brother / sister currently studying in this school)
Sibling :
Admission No. :
Sibling Name :
Sibling Class :
Application Form Information
Candidate Photo :
Class Applied for :
--Select Class--
NUR (2022-23)
LKG (2022-23)
UKG (2022-23)
I (2022-23)
II (2022-23)
III (2022-23)
IV (2022-23)
V (2022-23)
VI (2022-23)
VII (2022-23)
VIII (2022-23)
IX (2022-23)
X (2022-23)
XI (2022-23)
XII (2022-23)
Candidate's Personal Information
First Name :
Middle Name :
Last Name :
Date of Birth (dd-mm-yyyy):
D.O.B. Certificate No. :
Email (for communication) :
Aadhaar No :
Nationality :
Mobile No.
(for communication) :
Landline No. :
Gender :
--Select Gender--
Male
Female
Address :
City :
State :
Country :
PIN :
State of Domicile :
Category :
--Select Category--
EWS
GENERAL
OBC
SC/ST
Religion :
--Select Religion--
Hindu
Muslim
Sikh
Christian
Buddhist
Jainism
Others
Any medical condition
requiring School's special
attention :
Remarks :
Corresponding Relative :
--Select Corresponding Relative--
FATHER
MOTHER
School Transport Required :
Preference - 1:
--Select Bus Stop--
AGARWA
AGARWA(ZILA SCHOOL)
AJGARI MATH
AZGARI MATH
BADA BARIYARPUR
BALTHARWA
BALUA TAL
BANJARIYA
BARA BARIARPUR
BAZAR SAMITI ROAD
BELBANWA
BELI SARAI
BHAWANIPUR ZIRAT
CHAILAHA
CHAILAHAN BABU TOLA
CHANCHAL BABA MANDIR
CHANDMARI
CHHATAUNI
CHHOTA BARIYARPUR
CHINI MILL
CHOTTA BARIARPUR
CHOTTA BARIYARPUR
DHARMASAMAJ
DHARMSAMAJ
GANDAK COLONY
GANDHI CHOWK
GAYTRI NAGAR
GYAN BABU CHOWK
HAWAI ADDA
HENARY BAZAR
HENRI BAZAR
HENRY BAZAR
JAIL ROAD
JHAKHIYA
JIWDHARA
KACHHARI CHOWK
KACHHARI CHOWK(HAWAI ADDA)
KOLHUARWA
KOLUHARWA
KOTWA
KRISHAN NAGAR
KRISHNA NAGAR
MAJURAHA
MATHIYA ZIRAT
MATHIYA ZIRAT(NEAR EKRA SCHOOL)
MEENA BAZAR
MISCOT
NAKCHHED TOLA
PANCHMANDIR
PANDITPUR
PATAURA
PIPRAKOTHI
PIPRAKOTHI(BALTHARWA)
RAGHUNATHPUR
RAJA BAZAR
RATANPUR
SHANTIPURI
SIHULIYA
SINGHIYA HIBBAN
AZGARI MATH-D
HOSPITAL CHOWK
CHINI MILL- CHOTTA BARIYARPUR
AZGARI MATH-AMWA
SINGHIYA GUMTI
CHAILAHA PAKDIYA
MATHIYA DIH
MISSION CHOWK MOTIHARI
BARKURWA COMMITTIEE CHOWK
GOLDY PRESS
ARYASAMAJ CHOWK
BALUA
MATH BANWARI
MURDA CHOWK
AMBIKA NAGAR
HASINA CHOWK
JAMLA
KHUDA NAGAR
SUBHASH NAGAR
CHILWANIYA
TOWN THANA CAMPUS
ANANDPURI
AZAD NAGAR
TIWARI TOLA
RUPDIH N.H.
BOSCO MOTORS
EKTRA SCHOOL(DHARMSAMAJ)
Preference - 2:
AGARWA
AGARWA(ZILA SCHOOL)
AJGARI MATH
AZGARI MATH
BADA BARIYARPUR
BALTHARWA
BALUA TAL
BANJARIYA
BARA BARIARPUR
BAZAR SAMITI ROAD
BELBANWA
BELI SARAI
BHAWANIPUR ZIRAT
CHAILAHA
CHAILAHAN BABU TOLA
CHANCHAL BABA MANDIR
CHANDMARI
CHHATAUNI
CHHOTA BARIYARPUR
CHINI MILL
CHOTTA BARIARPUR
CHOTTA BARIYARPUR
DHARMASAMAJ
DHARMSAMAJ
GANDAK COLONY
GANDHI CHOWK
GAYTRI NAGAR
GYAN BABU CHOWK
HAWAI ADDA
HENARY BAZAR
HENRI BAZAR
HENRY BAZAR
JAIL ROAD
JHAKHIYA
JIWDHARA
KACHHARI CHOWK
KACHHARI CHOWK(HAWAI ADDA)
KOLHUARWA
KOLUHARWA
KOTWA
KRISHAN NAGAR
KRISHNA NAGAR
MAJURAHA
MATHIYA ZIRAT
MATHIYA ZIRAT(NEAR EKRA SCHOOL)
MEENA BAZAR
MISCOT
NAKCHHED TOLA
PANCHMANDIR
PANDITPUR
PATAURA
PIPRAKOTHI
PIPRAKOTHI(BALTHARWA)
RAGHUNATHPUR
RAJA BAZAR
RATANPUR
SHANTIPURI
SIHULIYA
SINGHIYA HIBBAN
AZGARI MATH-D
HOSPITAL CHOWK
CHINI MILL- CHOTTA BARIYARPUR
AZGARI MATH-AMWA
SINGHIYA GUMTI
CHAILAHA PAKDIYA
MATHIYA DIH
MISSION CHOWK MOTIHARI
BARKURWA COMMITTIEE CHOWK
GOLDY PRESS
ARYASAMAJ CHOWK
BALUA
MATH BANWARI
MURDA CHOWK
AMBIKA NAGAR
HASINA CHOWK
JAMLA
KHUDA NAGAR
SUBHASH NAGAR
CHILWANIYA
TOWN THANA CAMPUS
ANANDPURI
AZAD NAGAR
TIWARI TOLA
RUPDIH N.H.
BOSCO MOTORS
EKTRA SCHOOL(DHARMSAMAJ)
Father's Detail
Father Photo :
First Name :
Middle Name :
Last Name :
Email Id :
Mobile Number :
Landline Number :
Occupation :
--Select Occupation--
Business
Others
Service
Organization :
Office Address :
Qualification :
--Select Qualification--
Any Other
B.Ed
CTET
Graduation
High School/10th
Inter/+2
M.Ed.
M.Phil
Ph.D
Post Graduation
Designation :
Annual Income (In Rs):
Mother's Detail
Mother Photo :
First Name :
Middle Name :
Last Name :
Email Id :
Mobile Number :
Landline Number :
Occupation :
--Select Occupation--
Business
Others
Service
Organization :
Office Address :
Qualification :
--Select Qualification--
Any Other
B.Ed
CTET
Graduation
High School/10th
Inter/+2
M.Ed.
M.Phil
Ph.D
Post Graduation
Designation :
Annual Income (In Rupees):
No. of Son(s) :
No. of Daughter(s) :
Additional Information
Present Class :
Present School Name :
Board Name :
--Select Board Name--
CBSE BOARD
UPSC
Source of Information :
--Select Source of Info.--
Any other
Hoarding
Newspaper
RAHUL Z CAMPAIGNING
SANJAY KUMAR Z CAMPAIGNING
Word of mouth
Disclaimer
I/We understand that if any of the above information is found to be incorrect or false, my/our ward shall be automatically debarred from the selection / admission process without any correspondence in this regard. I/we also understand that the application / registration / shortlisting does not guarantee admission to my ward. I/We accept the process of admission undertaken by the school and I/we will abide by the decision taken by the school authorities. I have read all guidelines and information provided on the school website and promise to abide by the rules formulated by the school. I also understand and agree that in all matters pertaining to admission, the decision of the school authorities will be final and binding.
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