Seth Dwarka Prasad Bajaj Education Centre

Registration Form for Class:

Candidate's Name:
(in Capital Letters)

Student Type :

Day Scholar Day Boarding Hosteler

Date of Birth:
(dd-mmm-yyyy)

Category:

General OBC SC ST Others

Language:

Religion:

Physical Identification Mark:

Blood Group:

Height:
(In Cm.)

Weight:
(In Kg.)

Conveyance:

Self School Bus/Taxi

If School Bus / Taxi then Area / Pickup Point:

Duration of Candidate:
(Residence in U.P.)

School last Attended:

Mother's Name :

Mother's Occupation:

Father's Name:

Father's Occupation:

Mobile No. (1):

Mobile No. (2):

Permanent Address:

Local Address:

Group:
(Only for Class XI)

PCM PCB COM

Optional Subject:
(Only for Class XI)
(Optional Subject Can't change later)

Computer Hindi Economics

Passing Board:

CBSE Board UP Board ICSE Board Other State Board

Class Xth Roll No:

Passing Year(Class X):

Email