Omkar Education Institute

A. INFORMATION OF THE CHILD

Note: Please use capital letters only.

Admission required for:

Please enter the class for admission

We,

and

wish to admit our son/daughter/ward whose particulars are given below as a day scholar at Omkar Education Institute of Excellence.

Upload Photographs (Max 500KB each)

Father's Photo

Mother's Photo

Student's Photo

Please upload student's photograph (max 500KB)

First Name

Middle Name

Last Name

Gender

Male

Female

Date of Birth

Date of Birth in words

Blood Group

Religion

Caste

Nationality

Aadhar No.

Community

SC

ST

OBC

GEN

OTHERS

Languages Known

Mother Tongue

RESIDENTIAL ADDRESS

Full Address

Distance from school (in kms)

Father's Mobile No.

Father's E-mail ID

Mother's Mobile No.

Mother's E-mail ID

Preferred Phone for school SMS

Emergency Contact No.

Name of the person to be contacted

Relationship

FAMILY INFORMATION

Father/Guardian:

Name

Age

Educational Qualification

Occupation

Designation

Annual Income

Aadhar No.

Mother/Guardian:

Name

Age

Educational Qualification

Occupation

Designation

Annual Income

Aadhar No.

Single Parent (Tick if applicable)

Father

Mother

If child is sponsored (Name of sponsoring agency)

Permanent Address

Details of Brothers / Sisters of the student

Name	Age	Name of the Institution	Standard	Action

B. DETAILS OF PREVIOUS STUDY

Year	School	Standard/Grade	Grade/Marks obtained in final exams	Action

The previous school affiliated to:

SSLC

CBSE

ICSE

OTHER

Awards won so far in sports, arts or academics

MEDICAL HISTORY OF THE CHILD

BIRTH HISTORY:

Birth Details:

Normal

Caesarian

Forceps

Birth Cry:

Immediate

Delayed

Discharge from Hospital (Number of days)

Specialized care given in the hospital:

Yes

No

NICU

Extended hospital stay

If Yes, Explain:

HEARING:

Any difficulty observed:

Yes

No

Any Consultation with doctor done:

Yes

No

If Yes, Explain:

VISION:

Any Consultation with doctor done:

Yes

No

Use of Spectacles/Corrective Lenses:

Yes

No

MOTOR MILESTONES (Approx Months):

Sitting:

Standing:

Walking:

Speech:

Any medication taken for any medical conditions, such as attention deficit / thyroid (hypo/hyper)/any other condition:

Any Medication taken for general well being:

Any Allergy / any medical information that school should be aware of:

C. ENCLOSURES (All documents are mandatory at the time of admission)

The above documents (recently attested photocopies) must be produced along with the filled application form.

Upload Required Documents (PDF files only, max 1MB each)

Please upload all required documents as PDF files. Each file should not exceed 1MB.

Select documents to upload:

Please upload all required documents (PDF only, max 1MB each)

No documents uploaded yet.

Required documents: Birth Certificate, Transfer Certificate original copy (if applicable), Vaccination Card Copy, Blood Group Report, Passport size photos of child (5 copies), Passport size photos of parents (2 each), Aadhar card copy of parents & child, Copies of progress report cards for the last 3 years, Community Certificate: for Scheduled Castes, Scheduled Tribes or Backward Communities.

D. MISCELLANEOUS

How did you hear about Omkar Education Institute of Excellence?

If Others, please specify:

DECLARATION

I, ________________________ have the authority to admit my child/ward __________________________, into the school as the parent/ legal guardian. I undertake the responsibility of providing any evidence needed to support the information provided here, if necessary for any reason. I declare that the statements provided in this application are correct to my knowledge and if found otherwise, I shall abide by the decision of the management. I agree to abide by the rules, regulations and the fee structure of the school.

Signature of Parent / Guardian (max 500 KB each file)

Date

For Omkar Education Institute of Excellence Office use only

Admission Co-ordinator:

Head of the Institution:

Date:

Admission

OMKAR EDUCATION INSTITUTE

ADMISSION FORM

Upload Photographs (Max 500KB each)

Father/Guardian:

Mother/Guardian:

Upload Required Documents (PDF files only, max 1MB each)

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