Online Admissions - Chitkara International School, Panchkula -SchoolPad

ADMISSION FORM FOR PANCHKULA CAMPUS

INSTRUCTIONS

Kindly fill the full form. Do not leave any mandatory column blank, else the form will not be accepted.
Please attach/upload coloured passport Size Photograph.
Photocopy of self attested scanned copies of the mentioned documents to be submitted along with the admission application form.
Incomplete form will not be accepted.
Registration Fee: INR 100.
In case, you have any query please contact admission helpline numbers: +91 - 8288099489, 8288099490, 8288099491

STUDENT'S PERSONAL DETAILS

Admission for Class*

Gender*

Female Male Transgender

Student's Date of Birth*

Category*

Country*

State*

City*

Locality

Mobile Number *

E-Mail Id

ADDITIONAL DETAILS

Father's Details

Father's Occupation*

Father's Contact No

Mother's Details

Mother's Occupation

Mother's Contact No

STUDENT'S ADDITIONAL DETAILS

Date of Birth (in words)*

Age as on 31st March 2024*

Nationality

Indian Canadian American New Zealander Australian Norwegian Swedish

Languages Spoken at Home*

Student's Aadhaar Card Number

DETAILS OF THE PARENTS

Father's Nationality*

Father's Date of Birth*

Father's Academic Qualification*

Father's Occupation/Designation*

Father's Office Address*

Father's Annual Income*

Father's Email ID (Official)

Father's Mobile Number*

Father's Email ID (Personal Email ID)*

Father's Aadhaar Card Number

Mother's Nationality*

Mother's Date of Birth*

Mother's Academic Qualification*

Mother's Occupation/ Designation*

Mother's Office Address*

Office Telephone

Mother's Annual Income*

Mother's Email ID (Official)

Mother's Mobile Number*

Mother's Email ID (Personal)*

Mother's Aadhaar Card Number

To be filled by International/Foreign Students Only

Type of VISA you currently hold for entry to India

OCI

Yes No (Applied)

Name on the Passport

Place of Issue of Passport

Expiry of Passport (Date)

Expiry of VISA (Date)

Reason for change

IN CASE OF SINGLE PARENT (PLEASE SPECIFY)

Student lives with

Student lives with (if other, please specify)

Legal Guardian (if other, please specify)

Correspondence/Communication

Correspondence /Communication (if other, please specify)

Parents Divorced/Parents Separated/Other?

Parents Divorced/Parents Separated (if other, please specify)

DETAILS OF THE GUARDIAN (to be filled if the student lives/will live with a local guardian)

Guardian's Nationality

Indian Canadian American New Zealander Australian Norwegian Swedish

Guardian's Relation (with the student)

Guardian's Date of Birth

Guardian's Address (with pin code)

Guardian's Mobile No

Guardian's Email Id (Personal Email ID)

Guardian's Academic Qualification

Guardian's Occupation/ Designation

Guardian's Office Address

Office Telephone

Guardian's Email ID (Official Email ID)

Guardian's Aadhaar Card Number

ACADEMIC HISTORY (Details of Previous School(s), Play School or Creche (if attended)

Name and address of previous school(s), play school, creche attended*

Class/Grade Attended (Previous School)*

Board & Medium of Instruction*

Last Year's Marks Obtained (Previous School)*

Sessions Attended (From - To)*

Reason for the change*

RESULT OF THE LAST CLASS

1(c) Marks/Grade Obtained*

2(c) Marks/Grade Obtained*

3(c) Marks/Grade Obtained*

4(c) Marks Obtained*

5(c) Marks/Grade Obtained*

6(c) Marks/Grade Obtained*

TRANSFER CERTIFICATE

Transfer Certificate*

Transfer Certificate Number

Transfer Certificate Date of Issue

Student Registration Number (SRN)

Parivar Pehchan Patra (PPP)*

Permanent Education Number (PEN)*

PREVIOUS APPLICATION DETAILS

Have you ever applied before at Chitkara International School? (If yes, please share the class and year.)

Reason for leaving Chitkara International School?

Have you ever studied at Chitkara International School? (If yes, please share the class and year.)

Has the child ever been expelled/rusticated/not promoted to the next class by any school? (If yes, please give details.)

ACHIEVEMENT HISTORY

MEDICAL/HEALTH RECORD

Allergies (if any)

Physical Disability/Special Needs (if any)

Family Doctor's Name and Contact (if any)

DETAILS OF OTHER CONTACTS (Kindly mention two emergency contacts other than parents.)

1(b) Contact Relation (With the child)*

1(c) Contact Number*

1(d) Contact Correspondence Address*

2(a) Contact Name

2(b) Contact Relation (With the child)

2(c) Contact Number

2(d) Contact Correspondence Address

SIBLINGS/RELATIVES WHO ARE STUDYING/HAVE STUDIED AT CHITKARA INTERNATIONAL SCHOOL

1(a) Sibling/Relative Name

1(b) Sibling/Relative Class

1(c) Relative Relation's (With the child)

1(d) Sibling's /Relative's Year of Joining/Leaving

2(a) Sibling/Relative Name

2(b) Sibling/Relative Class

2(c) Relative's Relation (With the child)

2(d) Sibling's /Relative's Year of Joining/Leaving

SOLE POINT OF CONTACT (SPOC) NOMINATION

SPOCs ensure joint hand-holding of the child from both the ends together (i.e. the school and the home). Hence, the Home SPOC and the School SPOC work together for the child's improvement and hold a joint responsibilty in the areas of schooling. Parents are requested to nominate Home SPOC (the person who will be coordinationg with the School SPOC) by filling in the following detais.

SPOC Nominated from Home

(to be filled by the parent or person responsible for the student's education)

Main Home SPOC's Name*

Relation with the Child

Subject-Wise Home SPOC

(to be filled only if different from the main home SPOC else, mention N/A)

A SPOC from school will be duly assigned by the school for the holistic development of the student.

What expectations do you have from the school?*

Points to Consider

Have you interacted with the Admissions Counsellor?*

Yes No

Are you aware about the School's online communication system "SchoolPad"?*

Yes No

Have you read the Procedural Handbook uploaded on the school website?*

Yes No

Have you understood the fee structure?*

Yes No

Do you agree to pay the fee as per fee cycle of the school?*

Yes No

Have you submitted the required documents as mentioned in the document checklist?*

Yes No

If No, Please give reason regarding the pending document(s):

Tick to Continue*

I/We have read the details regarding school policies, fee structure, infrastructure, facilities, transport, etc. carefully and have understood them. I/We understand that the school policies need to be adhered to once the admission is done. I/We further certify that the information furnished in this form is true to the best of my/our knowledge and belief. I/We understand that by submitting this form, admission to my child is provisional subject to the submission of all necessary documents within a period of 30 days and shall be subject to terms and conditions laid down by the management. I/We promise to abide by all the rules and regulations of the school which have also been read over and explained to me/us in language known to me/us. I/We assure that changes, if any, will be notified to the school promptly.

Note: The Transfer Certificate needs to be submitted latest by 15th April 2024 or within 30 days of admission in order to fulfill the admission criteria and to close the admission process completely.

UPLOAD DOCUMENTS

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Student *

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Father *

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Mother *

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