GD Salwan Montessori School

Registration No._____________
Class: _____________

Rajendra Nagar, New Delhi-110060

Phone no: 011-25861674, 49254507
SERVICE BEFORE SELF

Website: http://gdsms.salwanschools.com
E-mail: gdsms@salwanschools.com

REGISTRATION FORM (2015-2016)

Affix recent
passport size
photograph
of the child

Affix recent
passport size
photograph
of Father

Affix recent
passport size
photograph
of Mother

GENERAL INSTRUCTIONS:
A. Registration Form should be filled by Parents in their own handwriting in CAPITAL letters only.
B. Tick or enter details, as appropriate.
C. Incomplete forms will not be accepted.
D. Submission of the form does not mean grant of admission.
E. Attested photocopies of supporting documents to be attached with the form.
F. Original documents should be produced at the time of verification.
APPLICANT'S INFORMATION
Name of the child

: _________________________________________________________________________

Date of Birth

: (in figures) ___________________ (in words) ____________________________________

Age as on 31.03.2015

: _____________________________

Place of Birth

: ___________________ Nationality: __________________ Religion: _________________

Residential Address

: _________________________________________________________________________

Gender: Male / Female

_________________________________________________________________________
Telephone (Landline)

Pin:
: _________________________________________________________________________

PARENT'S INFORMATION (For official records)

Father

Mother

Name
Age
Educational Qualification
(Please only one)

Graduate
Professional
Degree

Post Graduate
Ph.D

____________________________
Occupation
Designation
Office Address

Mobile
E-mail
Language
Spoken
Written

Graduate
Professional
Degree

Post Graduate
Ph.D

____________________________

INFORMATION ON SCHOOL SPECIFIC PARAMETERS

1

20 Points

Present Residential Address and distance

from School
(Kindly confirm whether living in own or
rented accommodation and residing therein
since when)

Upto 3 kms - 20 points.

Residing in areas covered by school notified bus routes and shall avail the school bus facility, will get 20 points.
Residing beyond 3 kms but can make own satisfactory transport arrangement will get 18 points.
2

Sibling
(Real brother/sister only)
Sibling studying only in GD Salwan Public
School/ GD Salwan Montessori School

Yes

First Born

4
5

No

10 Points

Yes

No

10 Points

Girl Child

Yes

No

20 Points

School Alumni (Father/Mother)

(Only GDSPS, Rajendra Nagar)
(Enclose authentic documents)

If Yes, year of passing

If no, name of your school

(A) Father

Yes

No

(B) Mother

Yes

No

Contribution towards any National cause or

Community Development Programme
(other than monetary contribution)
(If Yes, give details)
(Enclose authentic documents)

Give details:

Siblings Name
Class & Section

10 Points
(05+05)

10 Points

20 Points

Parents with proven track record

(National/State Award winners/outstanding
performance or achievement in any disciplineAcademics, Sports, Co-curricular activities like
Theatre, Dance & Music etc.)

100

UNDERTAKING

I/we hereby certify that the above information provided by me/us is correct and I/we understand that if the information is fo und to be
incorrect/false, my/our ward shall be automatically debarred from selection/admission process and admission, if granted, will be cancelled
by the school, without any further correspondence in this regard. I/we also understand that the registration/short listing does not guarantee
admission to my/our ward. I/we accept the process of admission undertaken by the school and I/we will abide by the decision taken by the
school authorities. I/we understand that the school is accepting the application form without prejudice to its rights and in this regard also, I/
we shall accept the decision of the school in this regard also.
Please register my child, named above, for admission to your school. I shall produce the original documents at the time of admission/
verification.

Signature of Father
Date:

Signature of Mother
Date:

Distance Range - Locality

[0-3 Kms.]
Old Rajendra Nagar, New Rajendra Nagar, NPL Colony, Karol Bagh, East/South Patel Nagar, Talkatora Stadium, Pusa Institute,
Prasad Nagar.
[Specified School Bus Routes]
Route 1:
Joshi Road, New Rohtak Road, Ramjas Road. Khalsa College, Dev Nagar, Kikarwala Chowk, Sat Nagar- School.
Route 2:
Inderpuri, Toda Pur, New Rajendra Nagar- School.
Route 3:
Kali Bari North Evenue President Estate, Gole Dak Khana, Gole Market, R.K.Mission Road, Chitra Gupta Road, Multani Dhanda,
Motia Khan, Sadar Thana, Idgah, Faiz Road- School.
Route 4:
Ramesh Nagar, Kirti Nagar, Karam Pura, Pandav Nagar, Ranjeet Nagar, West Patel Nagar, East Patel Nagar- School.

Note:

School provides transport facility on above given specified routes.

Parents, who have more than 2 children, need not apply.
The present admission process and admission, if granted, are without prejudice to the rights and contentions of the school.

GD Salwan Montessori School

Rajendra Nagar, New Delhi-110060
REGISTRATION SLIP
Regn. No. ________________________
Received Registration Form of _____________________________________________________________ son/ daughter of
_____________________________________________ on ______________________ for NURSERY / K.G.
1.
2.

Both the parents are requested to come for verification of documents on ____/01/2015 at _____________.
This slip is to be carried on the day of verification.

Dated: ___________________

(School Office)

(To be endorsed on Rs. 10/ Stamp Paper and to be notarized by Notary Public)
AFFIDAVIT
I,

________________________________,

s/o

d/o

w/o

________________________,

aged

about

______

years,

r/o

________________________________________, New Delhi do hereby solemnly affirm and state as follows:

1. That I am the (father/mother/guardian) of the applicant __________________________________ (childs name), whose
application is being submitted for admission to GD Salwan Montessori School, Rajendra Nagar, New Delhi for Academic Session
2015 - 2016.
2. (In case of first born child) That __________________________ (childs name) is my first born/only child and I have no other
child/children. (If there is a younger sibling). My younger child study in _____________________________, New
Delhi/Gurgaon and is ________years of age.
3. I will
avail the school transport.
personally drop my ward in my personal vehicle no. ____________________
(Please tick

one option.)

4. I have read and understood the contents of this Affidavit, which has been drafted by me / under my instructions and I say that the
contents thereof are true and correct to my knowledge.
5. I do not have more than 2 children.
DEPONENT
Verification:
Verified at New Delhi / Gurgaon on ______day of _____________ 2014/2015, that the contents of the affidavit of a foregoing are true and
correct to my knowledge, that no part of it is false and nothing material has been concealed therefrom.

DEPONENT

The documents (photocopies) to be attached along with the duly filled Registration Form at the time of submission:
Birth Certificate of the child issued by MCD or competent authority
Medical Certificate of the child if the child is suffering from any physical or mental disorder/impairment/disability
Copy of Medical Immunization Card of the Child
Residence Proof (Election Card/ Ration Card/ Passport/Adhaar Card/Driving Licence)
Sibling (Report Card and Latest Fee Receipt of the sibling)
First Born (Undertaking)
Alumni (Class XII School Leaving Certificate of GD Salwan Public School)
Documents to substantiate parameters at Serial numbers 5 & 6, if applicable.
*NOTE: Final admission is subject to the verification of the above mentioned documents [in original].