Fields with (*) are mandatory

Applicant's Information

Family Name:	Gender Male Female Other
First Name:	Date of Birth:
Middle Name:	Country of Birth:
Religion:	Nationality:
Caste:	Blood Group:
Language Known:	Mother Tongue:
Class Applying for:

Applicant's Address

Address	Country	Province	Municipality	Ward No	Local Place
Permanent
Temporary

Applicant's Detail of Previous School

Year	School	Address	Grade	GPA	IEMIS Code	Phone No.

Applicant's Health Information

Medical/ Psychological Condition If any

Family Information

Description	Father	Mother	Local Guardian
Name
Permanent Address
Present Address
Home Phone
Cell Phone
Email
Profession

Emergency Information

Family Name:
Relation to Child:	Mobile No:	Home Telephone No:

Applicant's Brother/Sister Information

Name	Age	Grade

i) How did you know about Dikshalaya Nepal Foundation?

Newspaper Website Teacher Hoarding Board Pamphlets Facebook

Others

ii) Please write expectation on your ward from Dikshalaya Nepal Foundation.

Facilities you want to take

Day Scholar: Day Boarding:

Boarding: Yes No Remarks

Transportation: Yes No

Documents

Birth Certificate:

Grade Sheet:

I, have the authority to admit my child/ward into the school as the parent/guardian. I undertake the responsibility of providing any evidence needed to support the information provided here, If necessary for any reason. I declare the statements provided in this application are created to my knowledge and if found otherwise, I shall abide by the decision of the management. I agree to abide by the rules and regulations and the fee structure of the school.

Signature Image
(Click here to add) Parent's Signature

2025-02-05

Date