Registration Form – Kaziranga English Academy

Please Fill The Following Form

Student First Name *

Student Last Name *

Date of Birth *

Gender *

Male
Female

Cast *

Blood Group *

Nationality *

Religion *

Mother Tounge *

Whether Minority

Name of the Previous School *

Class Attending or attended last *

Session

Board *

Whether having any session Gap

If Yes, mention the reason

Mother's Name *

Mother's Mobile Number

Mother's WhatsApp No

Mother's Email

Father's Name *

Father's Mobile Number *

Father's WhatsApp No

Father's Email *

Address for communication *

Permanent Address

I hereby declare that the entries made by me in the registration form are true to best of my knowledge. I slao declare to present the original documents immediately upon demand by the concern authorities. I hereby promise to abide by the admissible rules and regulations, concerning discipline and also to follow the Code of Conduct prescribed for the Students, as in force from time to time and subsequent changes/modifications/amendment made thereto. *

I agree
I don't agree

Name