(Admission will be strictly against vacancy)
Please Affix Latest Passport
Size Photograph in color.

(png/jpg) *

STUDENT
Please Affix Latest Passport
Size Photograph in color.

(png/jpg) *

MOTHER
Please Affix Latest Passport
Size Photograph in color.

(png/jpg) *

FATHER

GENERAL INFORMATION

I / We are Considering enrolment in Grade/ Class with effect from month/year.

Have you ever applied for admission at G.D.Goenka Schools     Yes   No

If Yes when? Academic Year   for which Class

PERSONAL DATA OF STUDENT

SURNAME   FIRST NAME*   MIDDLE NAME
Date of Birth *     Age as on 1st April   Nationality
Sex: Male   Female    Mother Tongue    Languages Spoken at home
Permanent Address *
City *   Pincode   Country   Email address *  
Home Tele#   Mob# *   Emergency Contact No  
Mailing Address   If different

HEALTH INFORMATION

Allergy/ Chronic ailment: If any Physical handicap/ disability: If any
Any other health problem

EDUCATIONAL BACKGROUND

Name of previous and present school attended
City/State   Country   From   To   Reason for leaving
Has the child ever been Expelled/Rusticated/Not promoted to next class by any School ?   Yes   No

If Yes, Please give details:

PARENTS/ GUARDIANS INFORMATION

Father's/ Guardian's Name   Age   Nationality   Education/ University
Mother's Name   Age   Nationality   Education/ University  
Relationship with child   Are parents living together   Yes   No  

PROFESSION/ OCCUPATION

FATHERS/ GUARDIANS Profession/ Occupation   Annual Income
Office Address
Telephone  Fax  Mobile#  Email
Mothers Profession/ Occupation   Annual Income
Office Address
Telephone  Fax  Mobile#  Email

OTHER RELATIVES INFORMATION

Real Brother/ Sister 1. Name  Age  School attending/attended
Real Brother/ Sister 2. Name  Age  School attending/attended
Relatives who are studying/have studied in the G.D. Goenka Schools  
Name  Class  Year of Joining   Relationship

REFERENCES

Name  Designation  Telephone
Address  City/State  Pincode
Name  Designation  Telephone
Address  City/State  Pincode

TRANSPORT

School Bus Facility   Yes  No    
Name

Class  
No (for office use)

  Please attached following documents with this from:

  1. Attested copy of birth certificate.
  2. For Class III and above, previous 3 years report cards.
  3. For Class III and above, Transfer Certificate to be produced at the time of admission. In case of inter state students, the Transfer Certificate shoud be counter signed by the education officer.
  4. Visiting/Business Cards of parent
  5. Passport size photographs (1 each of student and both parent/guardian )

  DECLARATION/ UNDERTAKING:

This from is intended to furnish information about the student and his/her family, without obligation on either side.
I/We Understand that:
If we wish to proceed further all entries in the Application form must be completed.
I/We certify that the information furnished in this form is true to the best of my/our knowledge and belief .

Signature of Parent/ Guardian

  Date

  Place

For Office Use Only

  Date of enquiry

  Admission Number

  Remarks
G. D. GOENKA PUBLIC SCHOOL
R.K. Puram, Khagual Road, Saguna More, Patna
Tele-7781004161-63
CORP. OFFICE - 303, 3rd Floor, Kamala Business Park
(Reliance Trends Building).Boring Canal Road,Patna
Tele:- 0612-2531000, +91-9771459848


info@gdgoenkapatna.com
Payment Details
Application Form Fee INR 1000
Registration Charges INR 2000
Total Fee INR
In case of any difficulty in submitting the form, please call on helpline 8249196429 Powered by SchoolBellQ*