Registration Form

Name of Student

Name of Parent/Guardian

Gender

Male Female

Date of Birth

Age

Height

Weight

Address

Mobile No.

Alternate Mobile No.

Parents Education Background..

Father's Qualification

Name of Institution / Collage/ School

Subjects

Mother's Qualification

Name of Institution / Collage/ School

Subjects

Father Occupation Details..

Father Occupation

Office Name/Address

Office Contact No.

Office Email ID

Mother Occupation Details..

Mother Occupation

Office Name/Address

Office Contact No.

Office Email ID

Transport Details..

Whether Transport Facility Required?

Yes No

Any Other Information about the child you would like to share...

Child Health Background..

Family Physician/ Pediatrician..

Name

Mobile

How did you get to know of blooms?

Please Specify...