For Office Use Only

Registration No………………..
Recipt No…………….Dated………….
Registration Fee Rs……………………

S. No

BIRLA SCHOOL PILANI

PIN-333031 (RAJASTHAN) Student’s Photo

REGISTRATION FORM
Please register the name of my son/ward for admission to your school

1. Candidate’s name in
full………………………………………………………………………..
2. Nationality……………………………………………………………………………………..
3. Father’s Name…………………………………………………………………………………
4. Mother’s Name………………………………………………………………………………..
5. (a). Guardian’s Name (if father not alive)…………………………………………………….
(b). Relationship………………………………………………………………………………
6. (a). Date of Birth (in figures and words)………………………………………………………
(b). Age on Last Birthday………………………………………………………………………
7. Admission Sought for class……………………………………………...as Hostler/days choler
(Elective Subjects (in case of admission to class XI)………………………………………….
8. (a) Name of the previous school attended………………………………………………………
(b) Class passed……………………………………..year………………………………………
(c) Name of the board to which school is affiliated……………………………………………..
9. Proficiency in games………………………………………………………………………………
Co-Curricular Activities……………………………………………………………………………
10. Father’s Guardian’s education and profession…………………………………………………..
Mother’s Education and Profession……………………………………………..
11. Addresses for Communication………………………………………………….
………………………………………………………PIN………………………
Tel. No. Res…………………….office………………STD Code……………..
12. Name and class of any real brother now in the school………………………….
13. The registration fee of Rs 800/-( Non-refundable) is paid herewith and I understand fully that the school on
accepting this fee and on registering his name, is not in anyway bound to provide a place but the admission
will be given only when a suitable vacancy arises and the student is found fit for admission to the school.
14. student will be denied admission if he does not confirm to age rule for admission as mentioned in the
prospectus. The student will be asked to withdraw if he is over-aged.
15. Registration form will be rejected if it is incomplete in any way. No corresponds will be entertained in this
regard.

I Certified that the above information is correct

Dated………………. Signature of the parent

( Mother or Father)

PTO
INDENTIFICATION CARD FOR THE ADMISSION TEST
BIRLA SCHOOL PILANI-(RAJ)
PHOTO FOR
IDENTIFICATION
CARD ONLY

Form No. ……….

Name………………………………………………………………..
Father’s Name.……………………………………………………..
Date of birth…………………………………………………………
Admission Sought for Class………………………………………...
Address………………………………………………………………
………………………………………………………………………
………………………………………………………………………

For Office Use Only

BIRLA SCHOOL PILANI-(RAJ)

Received Rs…………….R.No……………Date…………... Signature of Parent

Registration No……………………………………………. (Father of Mother)
( )
Signature

Note:- The Student Must bring this card with him at the time of admission test