REGISTRATION FORM - CLASS XI

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Personal Details

Name (in capitals): *
Gender: *
Email: *
Date of Birth (DD-MM-YYYY):
Phone:
Mobile:
Subject Combination:
PCMB: Physics, Chemistry, Mathematics & Biology


PCMC: Physics, Chemistry, Mathematics & Computer Science


PCBH: Physics, Chemistry, Biology & Home Science


Commerce: Accountancy, Business studies, Economics & Computer Application

Second Language:

Details of Schooling

Level of Study School last attended Medium Duration Reason for Leaving
Secondary

Academic Achievements

1. Board of Examination

Parental Details

Father's Name
Mother's Name
Profession
Profession
Office Address
Office Address
Phone No.
Phone No.

Non-Academic Achievements

Religion

Address

Permanent with Phone
Present with Phone (if any change)
Why do you prefer Girideepam Bethany Higher Secondary School and write your opinion
Declaration: The details given above are fully correct. I agree to follow all rules and regulations of Girideepam and in case of any violation, ready to accept any disciplinary action decided by the school authority.
I Agree (Student)
I Agree (Parent)