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APPLICATION FORM
(English - Capital Letter)
Name Of School
LEKSHMI VILASOM HIGH SCHOOL, POTHENCODE
Personal Details
Full Name Of Student *
Full Name of Student (Malayalam)
Gender *
Nationality *
State to which Student belongs to *
Aadhar Number of The Student *
Parent Details
Name Of Mother
Name Of Mother (Malayalam)
Name Of Father
Name Of Father (Malayalam)
Guardian *
If "Other" (Specify Relation)
Name of Guardian *
Occupation of Parent / Guardian
Annual Income (Rs)
Status
Address Details
House Name *
Street / Place *
Taluk
Revenue Dist.
State *
Whether Grama Panchayath, Municipality, Corporation ?
If Grama Panchayath (Specify)
District Panchayath
Block Panchayath
Name of Local Body
Post Office *
Pin Code *
Phone Number *
Student's E-Mail ID
Previous School Details
T. C. No.
T. C. Date
Date of Admission
Date Of Leaving
School Previously Attended
Admission Details
Date of Admission
Date of Birth (In Figures) *
Date of Birth (In Words)
Place of Birth
Blood Group
Religion *
Hindu, Christian, Muslim, Islam, Jain, Sikh, Buddist, Bahai, Secular, Judaism,, Non-Religion
Category *
(General, SC, ST, OB, OEC)
Caste
Class Of Admission
Standard Of Admission *
Division Of Admission
Student's Best Friend's Full Name (Optional)
(If the student want to sit with friend's class)
Current Details
Standard Studied *
Division Studied
Whether CWSN (Children With Special Needs)
If "Yes" Specify
If Learning Disability
Mother Tongue*
Medium Of Instruction *
First Language 1
Malayalam, Addl Eng, Addl Hindi, Sanskrit (A), Arabic (O), Urdu, Tamil, Kannada, Gujarati, Sanskrit (O)
First Language 2
Malayalam, Spl Eng, F Science, Spl Sanskrit, Arabic (O), Urdu, Tamil, Kannada, Gujarati, Sanskrit (O)
Third Language
General Knowledge, Hindi
Vaccination Details
Vaccinated
Two Identification Marks
Health & Sports
Does the Student have any health Issues? (If Yes Explain)
Does the Student Participated in any Sports? (Even Club level) (If Yes Explain)
Clubs
Upload Your Birth Certificate
Produce Original Certificate
Upload Your Aadhar Card
I Agree the Terms & Conditions *
Produce Original ID
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