IEM

IEM PUBLIC SCHOOL

Affiliated to ICSE, New Delhi

An initiative of IEM Group, Kolkata

*ADMISSION OPEN FOR All CLASSES* Admission office : GN 34/2, Ashram Building, Sector -V, Salt Lake, Kolkata-700091, Dial Us Today- 9007720041, 9831071659.
 
ADMISSION FORM FOR THE SESSION 2021-22
 
     
Note: Columns marked with * are compulsory to fill in.
Admission Number*
Admission To Class*
Academic Year* 
Student's Photograph*
Father's Photograph*
Mother's Photograph* 
Student Name* 
Gender

            
 
 Date of Birth*
(DD/MM/YYYY) 
 Nationality*
 
Preferred Second Language

            
 
Religion*
Mother Tongue*
Present Address*
Permanent Address*
   Same as Present
  Full Address: 
Pin Code  
Aadhar Number Of Child* 
   Details Of Preschool if applicable
Present School Name
Class
Address: 
   Candidates's Family Information ( All Names should be in full (including surname if any). Initials and titles are not allowed)
Father's Name*
Academic Qualification*
School/college* 
Occupation & Designation* 
Office Name & Address* 
Mobile*
Phone(O)*
Email* 
Mother's Name*
Academic Qualification*
School/college* 
Occupation & Designation* 
Office Name & Address* 
Mobile*
Phone(O)*
Email* 
Total Family Income Per Month* 
 Brothers/Sisters of student and school details
Name Of Sibling* Age* 
Class* Name of School/College*
Name Of Sibling* Age* 
Class* Name of School/College*
Name Of Sibling* Age* 
Class* Name of School/College*
 
Proficiency in Other Languages / Sports / Other activities* 
 Other family members staying with the Student (Brothers/Sisters/Grandparents etc.)
Name* Relationship* 
Age*
Name* Relationship* 
Age*
Name * Relationship* 
Age*
 
Has the child suffered from any major illness recently? If yes, please mention the illness.* 
 
Does the child have any chronic ailment/allergy/any other medical history?* 
 Contact Persons (In case of emergency)
Name*
Relation with the Student*
Mobile*
Phone(O)*
Phone(R)* 
Family Doctor's name* 
Mobile*
Phone(O)*
Phone(R)* 
Child's Blood Group* 
 What would you like your child to grow up to be ? (Express in brief )
 

We (the Parents / Guardian) promise to co-operate with the School in all matters and follow the rules and regulations of the School. We undertake to pay the School Fees, Transport Fees and other expenses, as it will be notified from time to time by School Authorities that pertain to the education and well-being of our child / children in IEM Public School. We will communicate one-to-one with the School Authorities regarding any clarifications or issues that may arise and not form groups or associations with other parents or third parties that may disrupt the peaceful working environment and atmosphere of the school in any way.


I/We hereby declare that all the information furnished in this form is correct.

Father's Signature*
Mother's Signature*
Date*
Date*