Delhi Public School, Knowledge Park V
GREATER NOIDA (WEST), DISTT. GAUTAM BUDH NAGAR, U.P. - 201308
APPLICATION FORM FOR ADMISSION (2023 -2024)
Mother's Photo
Father's Photo
Child's Photo
REGISTRATION NO. 4678 CLASS APPLIED FOR : PREP
STUDENT'S DETAILS
STUDENT'S NAME PRISHA DWIVEDI
DATE OF BIRTH 03/12/2018 Age as on 1st April, 2023 4 Years 3 Months
GENDER Male Female a
SMS MOBILE NO. 7002080166
BLOOD GROUP O-
RELIGION HINDU
LOCALITY GREATER NOIDA (WEST) SUB LOCALITY NA
LAST SCHOOL BRIGHT BEGINNING
NATIONALITY INDIAN EMERGENCY NO. 7002080166
GOVT. EMPLOYEE NO SINGLE CHILD YES
SOCIAL CATEGORY GENERAL FAMILY CHILD STATUS ONLY CHILD
PLACE OF BIRTH LUCKNOW AADHAAR NO. 268211683115
EMAIL ID skd.mech1@gmail.com THIRD LANGUAGE FRENCH
TRANSPORT YES
MOTHER TONGUE
PARENT INFORMATION
FATHER MOTHER
a). Name : MR SAURABH KUMAR DWIWEDI MS AKANKSHA TRIPATHI
b). Qualification : B.TECH POSTGRADUATE
c). Designation : MANAGER HOUSE WIFE
d). Occupation / Profession : SERVICE HOUSE WIFE
e). Occupation Code : CONSTRUCTION OTHER
f). Organization : TECHNIP ENERGIES NA
g). Official Address : NOIDA
:
h). Employer Name : TECHNIP ENERGIES NA
i). Employer Contact : 185674095 12
j). Mobile No. : 7002080166 8004883166
k). Email Id : saurabh.dwiwedi@technipenergies.com skd.mech1@gmail.com
l). Annual Income : 2200000
m) Aadhaar No : 892918992691 658969369224
. Alumni : NO NO
ARE YOU A STAFF IN THIS SCHOOL : NO
DOES STUDENT HAVE ANY SIBLING IN THIS SCHOOL : NO
S. No. Name Adm No. Class & Sec. presently studying in
1
PARENT'S PRESENT ADDRESS :
Y-1/1103 EROS SAMPORRNAM GREATER NOIDA WEST SECTOR 2 , PINCODE -201306
PERMANENT ADDRESS :
Y-1/1103 EROS SAMPORRNAM GREATER NOIDA WEST SECTOR 2 , PINCODE -201306
GUARDIAN INFORMATION
Guardian Name : Mobile :
Relation : Telephone No :
Qualification : Designation :
Designation (Other) :
Occupation : Aadhaar No. :
Email Id :
Address :
INSTRUCTION
1. Transfer Certificate will be required to be submitted within a period of one month, upon the grant of admission along
with 4 copies of passport size photographs.
2. Birth Certificate issued by Municipal Authorities in orginal, will be required upon the grant of admission in case of
classes Nursery to 1 Only.
3. The School provides transport facility but offers No Guarantee that a seat in the school bus will be offered, when
the buses are full to capacity/do not ply in the area of residence. It will be the responsibility of the parents/ guardians
to drop/collect the child from the specified bus stop. Bus fee shall have to be paid for the whole year.
4. Fixation of bus stop & any changes required will be the right of the School Transport Department.
DECLARATION BY THE PARENT/GUARDIAN
I/We hereby certify that the above information provided by me/us is correct, if the information is found to be
incorrect or false, the ward shall be automatically disqualified from Selection/Admission without any correspondance.
I/We understand that the Application/Registration does not guarantee admission to my ward. I agree to abide by the
rules and regulations of the institution.
Date : 27/01/2023 Signature of the Parent/Guardian
FOR OFFICE USE ONLY
Receipt No. : Date :
Rejected /Admitted to Standard :
