STUDENT ENROLLMENT FORM
Fields marked by asterisks (*) are required
Center Location:
*
Select Center Location
Matunga
Hughes Road
Chembur
Thane Indo Scots Global
Mulund
Wadala
Borivali
Malad
Ghatkopar
Bengaluru Sadashivanagar
Goa, Porvorim
Pune, Kothrud
Pune, Warje
Lalbaug
Chandivali, Powai
Bengaluru Yelahanka PDCSE
Thane Hiranandani
Age Group:
*
Select Age Group Name
10 Months to 2.5 years
2 years to 4 years
3 years to 5 years
4 years to 6 years
Date of Enrollment:
*
Name of the child
*
Date of Birth:
*
Current Age:
*
Gender of the child
*
Male
Female
Residential Address:
*
Mother's Name:
*
Mother's Contact Number:
*
Mother's Email Address:
*
Mother's Qualification:
*
Mother's Occupation:
*
Main Language Spoken:
*
Landline Number:
Father's Name:
*
Father's Contact Number:
*
Father's Email Address:
*
Father's Qualification:
*
Father's Occupation:
*
Name of the School:
*
School Timings:
*
Siblings if any (Name and Age):
*
Is your Child allergic to anything:
*
Any Medical Condition or Disability:
*
Child's Doctor's Name:
*
Doctor's Contact Number:
*
Emergency Contact Name (Apart from parents):
*
Emergency Contact Number:
*
Person authorised to pick up child:
*
Have you filled and duly signed the Declaration and Agreement Form?:
*
Yes
No
Have you signed and acknowledged the Rules and Regulations Sheet?:
*
Yes
No
Submit
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