LALIT MAHAJAN SARASWATI VIDYA MANDIR SR. SEC.

SCHOOL

NEAR CPWD COLONY, VASANT VIHAR, NEW DELHI-110057

CBSE REGISTRATION FORM SESSION:2021-2022

CLASS XI

SECTION ADMISSION NO. :

ADMISSION DATE :

NOTE: A) Please read the form carefully.

B) Fill the form in CAPITAL LETTER.

C) Use Blue / Black ball point pen only.

D) Once the registration is done, no change can be made.

FIRST NAME MIDDLE NAME LAST NAME

1. Candidate’s Name:

2. Mother’s Name:

3. Father’s Name:

4. Guardian’s:

5. Candidate’s Mail id:

6. Address : ...................................................................................................................................................................................................................................................................................................................................
7. Phone No. (Student & Parent): ...............................................................................................................................................................................................................................................................................................

8. Gender: Male Female

9. Date of Birth (DD/MM/YYYY) :

10. Tick the appropriate box –

i) Category: A) General B)SC C) ST D)OBC E)OTHERS

ii) Disability: A) Blind B) Dyslexic C) Spastic D) Deaf E) N.A.

ii) Minority: YES NO

10. MAIN SUBJECT:-

S.NO. SUBJECT CODE SUBJECT NAME MEDIUM (ENG/HINDI)

5.
6.
11.
ADDITIONAL SUBJECT:-

S.NO. SUBJECT CODE SUBJECT NAME MEDIUM (ENG/HINDI)

MAIN SUBJECT CODE: ADDITIONAL SUBJECT CODE:

1. ENGLISH CORE (301) 12. COMPUTER SCIENCE (083) 1. COMPUTER SCIENCE (083)
2. HINDI ELECTIVE (002) 13. PHYSICAL EDUCATION (048) 2. PHYSICAL EDUCATION (048)
3. HISTORY (027) 3. MATHEMATICS (041)
4. POLITICAL SCIENCE (028) 4. BIOLOGY (044)
5. ECONOMICS (030) 5. FINE ART (049)
6. MATHEMATICS (041) 6. HOME SCIENCE (064)
7. BUSINESS STUDIES (054) 7. MUSIC (034)
8. ACCOUNTANCY (055)
9. PHYSICS (042)
10. CHEMISTRY (043)
11. BIOLOGY (044)
12. Annual Income of Mother & Father (in Digits): ......................................................................................................................................................................................................................................................

(In Words) ........................................................................................................................................................................................................................................................................................................................

13. Aadhar Card No.: ........................................................................................................................................................................................................................................................................................................

14. Single child of parents: Yes No

15. Only Girl Child of parents: Yes No

DETAILS ONLY TO BE FILLED BY CLASS XI STUDENTS

B) Appeared in Class X in the year:…………………………………………………………………………………………………………………………………………………………………………………………………………..

17. Enclosure attached (please tick):

A) Photocopy of Aadhar Card

B) No of Photographs-

(Two passport size with name of candidate and date when photograph is being taken in current session)

C) Class X Certificate(if applicable)

D) Photocopy of Cast Certificate (SC/ST/OBC) (if any)

Declaration: The information provided by us is correct and true. We shall not request for a change in information at a later date.

18. Date:

Candidate’s Signature Class Teacher’s Signature Parent’s Signature