Loyola School Kalinganagar
REGISTRATION FORM (NURSERY to CLASS-IX ) - 2021 - 2022
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STUDENT
Student's Name
*
Enter Name
Date Of Birth
*
Enter Date Of Birth
Place of Birth
Admission requested for
*
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Nursery
LKG
UKG
I
II
III
IV
V
VI
VII
VIII
IX
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School last attended
Religion
*
NA
HINDU
MUSLIM
CHRISTIAN
SIKH
SARNA
JAIN
Mother Tongue
*
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Category
*
GEN
ST
SC
OBC
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Tribe name(if ST)
Gender
BOY
GIRL
Name of the Examination/Board
Class last attended
Blood Group
*
NA
O+ve
A+ve
B+ve
AB+ve
O-ve
A-ve
B-ve
AB-ve
A1B+
B+
O+
A1+
A2+ve
A1-ve
A2B+
OB+
A1B -ve
A2B-
Denomination (for Christian)
Nationality
*
Nationality Required
Aadhaar Card No.
DP/NON-DP
*
YES
NO
T.C No.(if any)
FATHER
Name(As it appears in identity proof)
*
Enter Father's Name
School attended (name)
Place of School
College attended (name)
Place of College
Aadhar Card No.
Educational Qualification
Designation
Name of Establishment/
Institution/Company
Occupation
Department
MOTHER
Name(As it appears in identity proof)
*
Enter Mother's Name
School attended (name)
Place of School
College attended (name)
Place of College
Aadhar Card No.
Educational Qualification
Designation
Name of Establishment/
Institution/Company
Occupation
Department
Present Address
Line 1.
*
Address Required
Line 2.
City
State
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NA
Andaman
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chattishgarh
Dadra & Nagar Haveli
Daman & Diu
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Lakshadweep
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Puducherry
Punjab
Rajasthan
Sikkim
Tamil Nadu
Telangana
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
District
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Pin
Country
Permanent Address
Line 1.
Address Required
Line 2.
City
State
Select
NA
Andaman
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chattishgarh
Dadra & Nagar Haveli
Daman & Diu
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Lakshadweep
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Puducherry
Punjab
Rajasthan
Sikkim
Tamil Nadu
Telangana
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
District
Pin
Country
Phone Number and Email Address
Phone (Residence)
*
Mobile (for SMS Alert)
*
E-Mail ID (1)
*
Email Id Required
Phone (Office)
Mobile(2)
E-Mail ID (2)
Other Children of Applicant’s parents (if any): -
Sibling
Yes
No
Name of Siblings
School (If applicable)
Class (If applicable)
Enter Name
Enter Class
Enter School Name
Documents
Student's Photo
*
Caste Certificate
Sibling ID Proof(xerox copy of first page of the school diary.)
Family Photo
*
Authentication certificate for DP Canididates
Baptism Certificate(Only for Christian)
Place
Date
I/We hereby certify that the information provided by me/us is correct and I/We understand that if the information is found to be incorrect or false, then my / our ward shall be automatically debarred from the selection / admission process without any correspondence in this regard. I / We also understand that this preliminary application does not guarantee admission of my/our 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.
Accept the declaration