Jayshree Periwal International School

Child's Details

School Name :

Select Session Year : 2024-2025 2025-2026

Select Time : Day Scholar(timings 8.00AM -2.00 PM) Day Boarding (8.00 AM to 4.30PM)

Applying for Grade* : Select grade * Play Group Nursery LKG UKG Class 1 Class 2 Class 3 Class 4 Class 5 Class 6 Class 7 Class 8 Class 9 Class 10 Class 11 Class 12

Joining Month* : Select Month April Onwards July Onwards

First Name* :

Middle Name :

Last Name :

DOB* (DD/MM/YYYY) :

Student Aadhar / Passport * :

Email. :

Place of Birth :

Religion* :

Mother Tongue :

Nationality* :

Languages Spoken :

Admission Date:

Gender* : Select Gender * Male Female

Child's Health detail

Height :

Weight :

Blood Group* :

Is the child Asthamatic : Select Yes No

Allergies (Medicine) :

Allergies (Food) :

Vision : Select Vision N/V F/V

Any other Medical Ailments :

Any Physical Handicap/Disability :

(Is the child undergoing any treatment such as cavities/braces etc :

Residential Address

House No. & Street* :

City* :

State* :

Country* :

Pincode* :

Home Telephone :

Child's passport / Visa details

Passport Number:

Visa Number :

Place of Issue:

Date of Expiry :

Father Details

Father Name* :

Mobile Number* :

Email* :

Qualification :

Occupation* :

Landline number :

Father Aadhar / Passport * :

Name of Organization :

Designation :

What'sapp Number :

Annual Income :

Mother Details

Full Name* :

Mobile Number* :

Email* :

Qualification :

Mother - Occupation* :

Landline number :

Mother Aadhar / Passport * :

Name of Organization :

Designation :

What'sapp Number :

Annual Income :

Guardian Details

Full Name :

Mobile Number :

Email :

Qualification :

Occupation :

Aadhar/Valid ID Proof :

Name of Organization :

Designation :

Local Address :

Emergency Contact Details

Person Name* :

Contact* :

Email* :

Relationship* :

Address* :

Details of Brother(s) / Sister(s)

Name :

Class :

School :

Name :

Class :

School :

Last School Attended & Achievements

Previous School Name* :

City / Country* :

Previous Class* :

Previous Board of Education. :

Proficiency Record

Performing & Fine Arts :

Academic Achievements :

Position Held (if any) :

Recommended by parent /Student /Other : Name

Students you know who have attended JPIS :

Reasons for withdrawal from last school

Reasons for joining JPIS :

Please indicate in the space below if you may be able to make any special contribution to JPIS, such as substitute teaching, classroom volunteer, room parent, field trip chaperone, library assistance, tutoring, specialized teaching (art, music,dance, drama), coaching sports, talks to classes describing some aspect of your work or hobbies.We are keen to use talents and resources that are available in the community and that can enrich our school programe.Thank you. :

How did you hear about us?