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School Name
 

School Address Line 1
 

School Address Line 2

School Address Line 3

School Email

State
--- Select One --- A. P. Andaman & Nicobar ARUNACHAL Assam Bihar Chandigarh Chhattisgarh Dadar & Nagar Haveli Daman & Diu Delhi Goa Gujarat H. P. Haryana Islands J. & K. Jharkhand Karnataka Kerala Ladakh Lakshadweep M P Maharashtra Manipur Meghalaya Mizoram Nagaland Odisha Puducherry Punjab Rajasthan Sikkim Tamil Nadu Telangana Tripura U. P. Uttarakhand West Bengal  

District
--- Select One --- --- Select One ---  

Name of the Teacher In charge/Guardian
Mr. Ms.  

Name of the Student 1
Mr. Ms.  

Date of birth Student 1
 

Class
 

Residence Address of Student 1
 

Pin Code
 

Email of Student 1
 

Mobile of Student 1
 

Upload your School ID Card
In case your current ID card is not available, may kindly upload your old ID card or your recent Photograph.
(only .JPG,.PNG allowed) File size should be between 10kb – 20kb.

Name of the Student 2
Mr. Ms.

Date of birth Student 2

Class

Residence Address of Student 2

Pin Code

Email of Student 2

Mobile of Student 2

Upload your School ID Card
In case your current ID card is not available, may kindly upload your old ID card or your recent Photograph.
(only .JPG,.PNG allowed) File size should be between 10kb – 20kb.