.: St.Raphael Co-Ed School :.

ST. RAPHAEL CO-ED SCHOOL

86/2, Jatkhedi, Misrod, Bhopal (M.P.) - 462047

Online Admission Form

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Admission Class :

Session

Subject Combination

2021-2022

Candidate's Profile

First Name :

Middle Name :

Last Name :

Gender :

Date Of Birth :

Mother Tongue :

Religion :

Cast Category :

Birth Place :

Birth State :

Blood Group :

Nationality :

SSSM ID :

Previous School :

Previous Class :

Family Data

Family Data :	Father :	Mother :	Guardian :
Name :
Education :
Occupation :
Working Place Address :
Monthly Income :
Permanent Address :
Local Address :
Phone Number Residence :
Phone Number Office: :

Other Detail

Student lives with :

Other relatives in Bhopal (a) :

Other relatives in Bhopal (b) :

Data On Documents

TC Number :

TC Date :

Student Aadhar Number :

Documents required

Father's Photo :

Mother's Photo :

Student TC :

Bank Detail

Bank Name :

Bank Account Number :

Bank IFSC :

Declaration

We herewith submit the child's original School Leaving Certificate of the last school attended / a true copy of the original Birth Certificate.
We declare that the information given by us is true.
we the undersigned agree to abide by the school rules viz. those printed in Handbook.

I/we agree to the terms and conditions and will abide by it.
I declare that all the above information are true and correct to the best of my knowledge. If any information is found false, St. Raphael Co-Ed School, Bhopal shall be free to cancel my ward's admission. I will abide by all the rules and regulations of St. Raphael Co-Ed School, Bhopal once the Admission is given to my ward.

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