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GAYATRI RESIDENTIAL ENGLISH MEDIUM SCHOOL(GREMS)
Kesaibahal
Kuchinda,Odisha
Mobile No.
7504095770
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Affiliated to CBSE New Delhi
Affliation NO.:1530236
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Admission Form
Father's Passport Photo (image jpeg formate, max size: 200kb)
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Father Name
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Phone/Mobile No
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Student's Passport Photo (image jpeg formate, max size: 200kb)
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Student Name
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Phone/Mobile No
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Mother's Passport Photo (image jpeg formate, max size: 200kb)
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Mother Name
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Phone/Mobile No
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1.Name of the Applicant
First Name
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Middle Name
Sur Name
*
2.Student's Adhar Number
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3.Select Gender
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Select
Male
Female
Transgender
4.Date of Birth (As in Birth Certificate)
*
Date of Birth in Words
*
5.Age on Date of Admission
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6.Religion
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Hinduism
Christianity
Muslim
Sikh
Other
7.Nationality
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Indian
Other
8.Mother Tongue
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9.Disadvantage Group
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10.Physical Disability
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Select
Yes
No
If Yes, Type of Disability
11.Student's Bank Account No.
*
12.Bank Name
*
IFSC
Branch
13.Father's Name
*
14. Occupation of Father
*
Father's Age
*
15.Father's Adhar No
*
16.Father's Mobile No
*
Father's Email
17.Father's Annual Income
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Select
Below 50,000
50,000-100,000
Above 100,000
18.Mother's Name
*
19. Occupation of Mother
*
Mother's Age
*
20.Mother's Adhar No
*
21.Mother's Mobile No
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Mother's Email
22.Mother's Annual Income
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Select
Below 50,000
50,000-100,000
Above 100,000
25.Complete Present / Postal Address
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Name
Village / Town
Post Office
Via
Police Station
District
State
PIN
26.Permanent Address
*
Name
Village / Town
Post Office
Via
Police Station
District
State
PIN
27. Name and Complete Address of Local Guardian
*
Name
Village / Town
Post Office
Via
Police Station
District
State
PIN
Academics
28.Class in which Admision is Desired
*
29.Name and Address of Institution last attended
*
30. Birth Certificate Details
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Birth Certificate No.
Birth Certificate Date
*
31. T.C. Details
T.C. No.
*
T.C. Date
*
32.Languages Known
*
33.Performance Record of Last Year : % of marks secured
*
34.If Admitted, The applicant proposes to reside :
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In Hostel
As Day-Scholar
35. Upload Medical Certificate(image jpeg formate, max size: 200kb)
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Disease (if any): Give Details
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