Admission Form

Full Name of the student:

Gender:

Male Female

Date of Birth:

Ethnicity

Brahmin/Chhetri Dalit Janajati Madhesi Others

Religion

Hindu Buddhist Christian Muslim Others

Nationality

Admission sought for Grade:

Type

Day-scholar Boarder Day-boarder

Taking Bus Facility?

Yes No

Nearest Bus Stop:

Name & address of previous school:

Grade:

Name:

Occupation:

Phone No:

Email Address:

Province:

District:

Gaupalika / Nagarpalika:

Ward No:

Tole / Village:

Name:

Relation:

Address:

Contact No:

Email:

No. of children in the family(same parent):

Position of the child:

Any health complication?

Pushpasadan Secondary School