VISHWAPRAJNA SCHOOL

No 20, 3rd Stage, Kanakadasanagar, Dattagalli, Mysuru – 570 033
Phone: (0821) 2347153. Email :: info@vishwaprajnaschool.ac.in

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Nursery

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Name *

Sex

Age & Date of Birth

(Birth Certificate to be enclosed)

& & the

Place of birth (Taluk / District)

Class to which admission is sought

Mother Tongue

Last School attended

Standard last attended

Date of Leaving the previous school

Father's Name & Qualification

Mother's Name & Qualificiation

Father's Occupation / Annual Income

Nationalality / Religion / Caste

Wheather belongs to SC / ST

(Certificate to be enclosed)

Residential Address of Parents / Guardians

Office Address

Phone / Mobile / Residence / Office Number

I hereby agree to abide by all the rules prescribed by the Instition *

I request that the above mentioned pupil may admit to I hereby agree to abide by all the rules prescribed by the Institution

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