Jayshree Periwal High School

Admission Form

* Kindly upload the scanned copy of Documents of Student applying for admission up to 10mb.
* Please keep these documents ready before starting the process to fill out the admission form *Birth Certificate, *Passport size photograph, *Marksheet(Previous class),Transfer Certificate, Aadhar card (Student), Caste Certificate (If Applicable)
* After submitting the form Kindly wait till you receive the message on your computer screen," Your Response is Recorded"
* This admission form is required to be filled up only once.
* All the contact details and Email IDs will be used for future communications.

Student Details

Select Session Year :

Applying for Grade* :

First Name* :

Middle Name :

Last Name :

DOB* (DD-MM-YYYY) :

Gender* :

Email (Student) :

Place of Birth :

Blood Group :

Nationality :

Aadhar Card No. :

Category :

Contact Number :

Third Language (VI - VIII)

Second Language (Grade IX)

Whether the candidate is Single Girl Child :

Residential Address

House No. & Street :

City :

Country :

State :

Pincode :

Parent Details ( If single parent kindly click NA for one of the parents )

Father Details ( NA )

Father Name* :

Qualification :

Occupation :

Designation :

Name of Organization :

Annual Income :

Email :

Mobile Number* :

Office Mobile :

Official Address :

Residential Address :

Address Same as the Above

Mother Details ( NA )

Mother Name* :

Qualification :

Occupation :

Designation :

Name of Organization :

Annual Income :

Email :

Mobile Number* :

Office Mobile :

Official Address :

Residential Address :

Address Same as the Above

Contact No (In case of Emergency)

Contact No (In case of Emergency) :

Local Guardian Details (To be filled in case father/mother is not the guardian)

Full Name :

Qualification :

Occupation :

Designation :

Relation with the candidate :

Email :

Residential Address :

Official Address :

Mobile Number :

Office Mobile :

Proficiency Record

Academic Achievement(Olympiad, NTSE, KVPY etc) :

Sports & Games Achievement(District/State/National/Int) :

Co Curricular Activities :

Last School Attended & Achievements

Transfer From Sister Concerned :

Name of the School* :

Name of the City :

Previous Class* :

Overall percentage in the previous Grade* :

Examination Board of Previous School* :

Reason for withdrawal from the previous school :

Details of Brother(s) / Sister(s)

Voluntary Services

Please indicate in the space below if you may be able to make any special contribution to JPHS, such as substitute teaching, classroom volunteer, room parent, field trip chaperone, library assistance, tutoring specialized teaching (art, music, dance drama), coaching sports, guest lectures related to your area of interest We are keen to use talents and resources that are available in the community and can enrich our school programme. Thank you.

Mode of Transport

Interested in Availing Transport facility*

Yes

No

Would you be availing Boarding Facility ?*

Yes

No

Please upload the self attested copies of the following documents.

The one with Asterisk is mandatory

Birth Certificate* :

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Birth Certificate

Passport Size photograph (Recent & coloured)* :

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Upload Student Image

Marksheet (Previous grade)* :

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Marksheet (Previous grade)

Transfer Certificate (Original to be submitted in a hard copy at the school office) :

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Transfer Certificate

Aadhar Card :

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Aadhar Card

Caste Certificate :

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Caste Certificate

Father Aadhar Card :

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Aadhar Card

Mother Aadhar Card :

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Aadhar Card

Father Signature :

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Father Signature

Mother Signature :

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Mother Signature

How did you hear about us?

Parent / Guardian's Declaration
I understand that
1.  The filling of Registration Cum Admission Form does not guarantee a seat in the school. The admission of my ward will be examined on the basis of availability of seats, his/her academic progression, Interaction, and only if the applicant fulfils the overall criteria for admission as per the School norms.
2.  Till the Original Transfer Certificate of the child is not deposited, his/her admission will be deemed provisional.
3.  The amount once paid as fee is NON REFUNDABLE & NON TRANSFERABLE. Only Caution Money can be claimed on producing the original receipt of the fee paid. Caution Money cannot be claimed after six months of the child leaving school.
4.  Payments arriving after expiry of Pay by Date shall attract Late Fee Payment @ Rs. 50/- per day.We have made satisfactory arrangements for remittance of school fees within due dates without waiting for a reminder from the school.
5.  It is understood that tuition fee of the School is payable quarterly and not monthly. As such, if my ward attends school for a single day in a quarter (April, July, October and January), the fee for the entire quarter will be charged.
6.  Once admitted, the child will not be entitled to refund of fee deposited, except caution money, irrespective of when the child was admitted, in case I / we wish to withdraw him/her.
7.  The fee of the school as notified to us is commensurate with the infrastructure, faculty and facilities available in the school.
  I agree* 8.  The school retains the right to determine the fee slabs and the fee payment structure.
9.  I take full responsibility of the financial commitment that I have decided to undertake into.
10.  I understand to maintain dignity and decorum while interacting with the Principal/Coordinator/Class Teacher and any other staff of the school.
11.  
a) The discipline plays a very important role in our life hence the school would take some measures to enforce discipline in our ward. We shall abide by the school management’s decision and action regarding the matters pertaining to discipline.
b) Not make derogatory remarks/ statements against Management / Administration, Principal and staff of the school.
12.  
a) Mobile phones, I Pods, expensive gadgets, valuables etc. are NOT PERMITTED. School is not responsible for their loss and if found with the students,it will be confiscated & not returned.
b) I am aware that my ward might be going for Inter School Activity/ Workshops/Competition/Field Trips/Sports Meet. I hereby readily agree that I shall not have any concerns in sending him for the same.
13.  I hereby declare that the information given by me in this admission form is true and correct to the best of my knowledge and belief.
14.  The children while running, playing, commuting or going on excursions and field trips may get physically injured or hurt overwhich the school may not have control and for that the school will not be liable. The school will not be responsible for the child beyond the exit gates,
1.  The school shall not be responsible for:
(a)   A deliberate or intentional act done by the student which results in injury or is fatal.
(b)   Any injury to the student on account of accident or mishap on account of any kind of rash and negligent act including driving of motor vehicle by himself or vehicle carrying him/her and driven by some one else.
(c)   Any injury caused to the student while playing, running and engaging with peers and any activity or due to the act of nature or otherwise during normal course of his/her studying or attending the school.
  I agree* (d)   The student bunking from the school and thereafter watching movie, joining, associating or mixing with antisocial elements, drug traffickers and thereby invoking the provision of I.P.C and Cr. P.C.
(e)   If the student, out of despair and disgust, injures or tries to injure him/her-self.
(f)   Any natural or manmade mishap or untoward happening takes place during picnic, outing, educational tours travels, sightseeing, school functions and alike.
(g)   Sustaining injury or loss of life and property on account of acts of indiscipline or quarrel amongst students inside and outside the school.
    Health Declaration:
1.   Parents should declare health, physical, physiological, learning concerns of their child along with certificates, prescription, instruction, etc.
  I agree*
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Upload Physical Document
    Kindly note:
1.   The school does not sell books, stationery, uniform, accessories etc and does not compel students to buy from any particular vendor.
2.   In case of children commuting by parents vehicle/ private vehicle, the parents have to ensure that the police verification of the driver has been done.
  I agree* 1.   Having read carefully the rules, regulations and procedures laid down by the school, I am desirous of having my child educated at Jayshree Periwal High School, Jaipur. I hereby agree to abide by the School’s code of conduct.
2.   I understand that only after the payment of Rs. 1500/- as the Registration Fee my application will be processed further.