JP Academy

Class Sought for Admission*

Name of the Child*

Email Address*

Date of Birth

Place of Birth

Nationality*

Religion

Gender

Male

Female

Caste

Courses

Aadhar Card No.

High School %

Intermediate(10+2) %

Graduation %

RECORD OF PREVIOUS EDUCATION :

Mention Hobbies / Interests / Games and Sports / Prizes won.

If yes, Please give details

Hostel accommodation required :

Yes

Name of Father*

Occupation of Father*

Name of Mother*

Occupation of Mother

Annual Income Rs

Telephone No. (Resi.)*

Full Postal Address of Parent with Telephone No. (Residence)*

Permanent Home Address

Upload Photograph

Registration Form