::The Choice School::

APPLICATION FORM 2011-2012

THE CHOICE KINDERLAND

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Standard to which Admission is sought:

AGE CRITERIA:

LKG : Children born before 01-12-2007 are eligible. Preference will be given to children who are closer to 4-years of age as on June 2011.

PRESCHOOL:Children born before 01-11-2008 are eligible. Preference will be given to children who are closer to 3-years of age as on June 2011.

* Indicates Mandatory fields

* Name of the child

As it should appear in the School leaving certificate (copy of the birth certificate to be enclosed)

* Date of birth (in figures) Click

Sex:

* Date of birth (in words)

Identification Marks

*Place of birth *Nationality

*Religion Caste OBC/SC/ST

* Father's Name

Educational qualifications

Occupation

Office Address

Telephone No

* Mother's Name

Educational qualifications

Occupation

Office address

Telephone No E-Mail

* Residential Address

* Telephone No E-Mail

* Languages spoken at home

Previous Schools, if any

Allergies, if any

Family Doctor/Hospital Doctor's Telephone Number

FAMILY

Is it extended or nuclear? How many members are there?

How many brothers and sisters?

1) Name Age School Std Div

2) Name Age School Std Div

3) Name Age School Std Div

HEALTH

Height Weight Blood group

Immunisation taken 1) 2)

Had a dental checkup? Measles? Mumps? Chicken Pox? Jaundice?

Any other illness ?

ACTIVITIES

(Select the relevant)

Likes drawing/painting? Reading?

Singing Cycling/Swimming

Games? Any other?

FAVOURITES

Person outside family Game

Food Drink

Toy Colour

Hobby/activity Pastime

How would you describe your child?

Is there anything about your child that bothers you?

How much time do you spend with him/her?

What would you like your child to be ?

Special Talents, if any?

What are your expectations from your child's school?