Srushtee Pre School
17B, Kuberan Nagar 2nd street, Off Ram Nagar South 12th Main Road,
Madipakkam, Chennai, Tamil Nadu 600091
Child's Details :
Child's full name
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Gender
Boy
Girl
Date of Birth
Age(in years)
Nationality
Choice of Program
Play Group
Pre KG
Jr KG
Sr KG
Parent Details :
Father's Name
Mother's Name
Profession
Profession
Company Name
Company Name
Contact Number
Contact Number
E-Mail ID
E-Mail ID
*In case of emergency, best contact(s) and Contact numer(s) to reach
(1)Contact Name
Contact Number
(2)Contact Name
Contact Number
Is Child with a legal guardian?
Yes (If Yes,Please Specify)
No
Name
E-Mail ID
Address
Other Information :
Child's specific interests, if any
Familiar Language(s) of your child
Medical Conditions, if any
Allergies, if any
If under any medication, please specify
Any other information about the child that you wish to share
Declaration:
I/We hereby declare that all the information furnished in this application form are genuine and true.
I/We have also read the rules and regulations of the school and agree to abide by them.
For office use :
If any Comments
