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:
SCIENCE STREAM
PCMB: Physics, Chemistry, Mathematics & Biology
PCMC: Physics, Chemistry, Mathematics & Computer Science
PCBC: Physics, Chemistry, Biology, & Computer Science
PCBM/F: Physics, Chemistry, Biology & Malayalam/French
PCBI: Physics, Chemistry, Biology & Informatics Practices
COMMERCE STREAM
BEAC: Business Studies, Economics, Accountancy & Computer Science
BEAI: Business Studies, Economics, Accountancy & Informatics Practices
BEAM: Business Studies, Economics, Accountancy & Maths
BEAM/F: Business Studies, Economics, Accountancy, Malayalam / French

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 Central 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)