ZILLA PARISHAD HIGH SCHOOL MUJAHIDPUR

MDL: KULKACHERLA | DIST: VIKARABAD | UDISE : 36240700815

APPLICATION FOR ADMISSION AY : 2026-2027 ( VI TO X )

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PEN
Adm. Number
Date of Admission
1. Name of the Pupil in Full
2. Mother Tongue of the Pupil
3. Date of Birth
(in figures)
(in words)
4. Aadhaar Card No
5. Height
6. Weight
7. Nationality and State
8. Religion
9. Caste with Sub Group
10. Living with Parent / Guardian
11 (a). Name of Mother
11 (b). Name of Father
11 (c). Father Occupation
11 (d). Mother Occupation
12 . Full Address
H.NO:
VILL:
MDL:
DIST:
STATE & PIN:
13(a). Name of Guardian
13(b). Guardian Occupation
13(c). Guardian Address
14. Previous School Details
15. TC / Record Sheet Details
16. Class into which Admission is Sought
17. Medium of Instruction
18. First Language
19. Second Language
20. Course Applied
21. Identification Marks
1.
2.
22. Previous School History
23. Health Issues
24. Mobile Number

I DECLARE THAT THE STATEMENT GIVEN ABOVE IS CORRECT AND THAT THE PUPIL HAS NOT ATTENDED ANY OTHER SCHOOL BESIDE THESE MENTIONED ABOVE.
Station : ZPHS MUJAHIDPUR SIGNATURE OF THE PARENT/GUARDIAN
Date:
ORDER OF THE HEAD OF THE SCHOOL
SIGNATURE OF THE HEAD OF THE INSTITUTION

Date: