ADMISSION FORM FOR PANCHKULA CAMPUS
2024-25
INSTRUCTIONS
  1. Kindly fill the full form. Do not leave any mandatory column blank, else the form will not be accepted.
  2. Please attach/upload coloured passport size photograph.
  3. Self-attested scanned copies of the  documents mentioned under 'Upload Documents ' should be submitted along with the admission application form.
  4. Incomplete form will not be accepted.
  5. A registration fee of INR 150 should be submitted at the time of registration.
  6. Admission fee once deposited shall not be refunded.
  7. In case you have any query, please contact the school admission helpline numbers: +918288099489, +918288099490 and +918288099491.
STUDENT'S PERSONAL DETAILS
Admission for Class*
Gender*
Female Male Transgender
Student's Name*
Father's Name*
Mother's Name *
Student's Date of Birth*
Category*
CONTACT DETAILS
Address*
Country*
State*
City*
Locality
Pincode
Mobile Number *
E-Mail Id
ADDITIONAL DETAILS
Father's Details
Father's Occupation*
Father's Contact No (WhatsApp)
Mother's Details
Mother's Occupation*
Mother's Contact No (WhatsApp)
STUDENT'S ADDITIONAL DETAILS
Date of Birth (in words)*
Age as on 31st March 2025*
Nationality
Indian    Canadian    American    New Zealander    Australian    Norwegian    Swedish    
Place of Birth*
Mother Tongue*
Languages Spoken at Home*
Religion*
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*
Organization*
Father's Office Address*
Office Telephone*
Father's Annual Income*
Father's Email ID (Official)
Father's Mobile Number (WhatsApp) *
Father's Email ID (Personal Email ID)*
Father's Aadhaar Card Number
Father's PAN Number
Mother's Nationality*
Mother's Date of Birth*
Mother's Academic Qualification*
Mother's Occupation/ Designation
Organization
Mother's Office Address
Office Telephone
Mother's Annual Income
Mother's Email ID (Official)
Mother's Mobile Number (WhatsApp)*
Mother's Email ID (Personal)*
Mother's Aadhaar Card Number
Mother's PAN 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
Passport Number
Expiry of Passport (Date)
Expiry of VISA (Date)
VISA Number
Reason for change
IN CASE OF SINGLE PARENT (PLEASE SPECIFY)
Student lives with
Student lives with (if other, please specify)
Legal Guardian
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)
In the case of Single Parent or Guardian, Kindly Complete the School Admission Undertaking form and provide the relevant legal documents to support the information mentioned above. This information is requested in the interest of child's safety and security.
DETAILS OF THE GUARDIAN (to be filled if the student lives/will live with a local guardian)
Guardian's Name
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
Organization
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*
Gap Year*
RESULT OF THE LAST CLASS
1(a) Subject Name*
1(b) Max Marks*
1(c) Marks/Grade Obtained*
1(d) % Marks*
1(e) Remarks*
2(a) Subject Name*
2(b) Max Marks*
2(c) Marks/Grade Obtained*
2(d) % Marks*
2(e) Remarks*
3(a) Subject Name*
3(b) Max Marks*
3(c) Marks/Grade Obtained*
3(d) % Marks*
3(e) Remarks*
4(a) Subject Name*
4(b) Max Marks*
4(c) Marks Obtained*
4(d) % Marks*
4(e) Remarks*
5(a) Subject Name*
5(b) Max Marks*
5(c) Marks/Grade Obtained*
5(d) % Marks*
5(e) Remarks*
6(a) Subject Name*
6(b) Max Marks*
6(c) Marks/Grade Obtained*
6(d) % Marks*
6(e) Remarks*
Third Language
Subject Name
Max Marks
Marks Obtained
% Marks
Remarks
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
Achievements
MEDICAL/HEALTH RECORD
Blood Group
Allergies (if any)
Physical Disability/Special Needs/Significant Medical History (if any)
Family Doctor's Name and Contact (if any)
DETAILS OF OTHER CONTACTS (Kindly mention two emergency contacts other than parents.)
1(a) Contact Name*
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
What is SPOC?
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*
Contact Number
Relation with the Child
Email ID
Subject-Wise Home SPOC
(to be filled only if different from the main home SPOC else, mention N/A)
Subject 1
SPOC
Relation
Subject 2
SPOC
Relation
Subject 3
SPOC
Relation
Subject 4
SPOC
Relation
Subject 5
SPOC
Relation
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    
I Understand that the fee, once paid, is non-refundable.*
Yes    No    
Have you submitted the required documents as mentioned in the document checklist?*
Yes    No    
If answer to point 7 above is No, please mention the details of the pending documents which are yet to be furnished:
Undertaking
Tick to Continue*

I/We have read the policies, fee structure, infrastructure, facilities, transport, etc. , carefully and understood them, including that the admission fee once paid/deposited shall not be refunded. I/We understand to make timely payment of fee as per fee cycle of the school. I/We understand that the school policies need to be adhered to once the admission is done. 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. I/We have understood that in case there are any documents which are pending (as specified above) the admission of my child shall be provisional and the school shall be free to cancel the admission in case these documents are not furnished by me/us to the school against a valid receipt within a period of 30 days of signing this application. I/We acknowledge and accept that should any material particulars be concealed during the admission process; the school retains the absolute right to review the admission at any time. I/We further certify that the information furnished by me/us in this form is true and correct to my/our knowledge and no part of it is false and nothing material has been concealed therein.    
Note: The Transfer Certificate needs to be submitted latest by 20th April 2025 or within 30 days of admission in order to fulfill the admission criteria and to close the admission process completely.
How did you hear about us?
Other details
Other Option
Single Girl Child    Specially Abled    NA    
PinCode
Add Permanent Address ( If Different)
UPLOAD DOCUMENTS
Upload Photo
Student *
Click Photo or
Remove
Father *
Click Photo or
Remove
Mother *
Click Photo or
Remove
Undertaking

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