Bridgewell Global School

Student Information (As per the Birth Certificate) * Indicates a Mandatory Field

Admission into Std. *

Name of the Student *

Date of Birth *

Gender*

Male Female

Details Information of Parents

Name of the Father *

Name of the Mother *

Aadhar Number of Father *

Aadhar Number of Mother *

Father's Qualification

Mother's Qualification

Father's Occupation

Mother's Occupation

Father's Annual Income

Mother's Annual Income

Father's Whatsapp No.

Mother's Whatsapp No.

Present Address

Present Address of the Parent *

P.O. *

P.S. *

Dist/City *

State *

PIN *

Phone/Mob. *

Same as Present Address

Permanent Address

Permanent Address of the Parent*

P.O. *

P.S. *

Dist/City *

State *

PIN *

Phone/Mob

Local Guardian of Student

Full name of the Guardian

Relationship With the Student

Address of the Guardian

P.O.

Dist

State

Phone/Mob.

Information of Last School Attended

Name of the School last attended *

Class in which he/she was studying *

Result of the Last Examination: *

Children with special need (CWSN)

Yes No

Give brief note on health condition of the student: *

Whether the student is physically challenged

Yes No

Means of Transportation to the school: *

Subject for IX/X

2nd Language *

Hindi Odia Sanskrit

3rd Language (Studied in Class VIII other than 1st & 2nd)*

Year of Passing (Third Language)*

Additional Subject

Computer Science Yes No

Subject for XI/XII

Optional Subject (Any 2 Subject) *

4th Optional

5th Optional

6th Optional (if any)

Board roll no of class X *

Year of Passing Class X *

Name of the Board *

CBSE ICSE STATE BOARD Other

Uploads (Upload file size maximum 500kb.)

Upload Image(Passport Size Photo) ( .png OR .jpg Only )

Upload Signature of Father/Guardian ( .png OR .jpg Only )

Upload Signature of Mother ( .png OR .jpg Only )

Upload Caste Certificate ( .pdf OR .png OR .jpg Only )

Upload BPL Card ( .pdf OR .png OR .jpg Only )

Upload Disability Certificate ( .pdf OR .png OR .jpg Only )

Upload Aadhar card ( .pdf OR .png OR .jpg Only )

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NOTE BY :- APPLICATION FORM WITH INCOMPLETE INFORMATION/FALSE ENTRY ARE LIABLE TO BE REJECTED AND ADMISSION WILL BE FORFEITED