HIGHFIELDS INTERNATIONAL SCHOOL (An Institution of Balaji Educational Society) Purushothapuram, Visakhapatnam - 51 No: REGISTRATION FORM 1. Name of the Child {in Capital Letters} D D M M Y Y [in words] 2. Date of Birth[in figures] 3. Age as on 1st April of current Academic Year: 4. Sex [Please put a tick] Male Years Female Months Days 5. Nationality of the child Caste 6. Religion 7. Name of the previous School Applying for Class 8. Studying in Class 9. Languages Known Tel Parents’ details 10. Name 11. Date of Birth 12. Nationality 13. Academic Qualification 14. Occupation 15. Designation 16. Name of Organization 17. Office / Business Address 18. Residential Address 19. Phone No (s) 20. Mobile No (s) 21. E-mail address Eng Father Hin French Mother Sanskrit Others LOCAL GUARDIAN 22. The staff ’s child please mention the name of the staff member 23. Details of any brothers or Sisters [not cousin] studying in Balaji Institutions. Name of the child Name of the Branch Class / Sec 24. Areas in which you can contribute towards the enrichment of the School Cultural Media Medical Academic Sports [please put a tick against your choice] Any Other Please elaborate your choices 25. If school transport is required Yes No INFORMATION : Kindly note that due to limited number of seats, it will not be possible to admit all applicants. The registration made here does not in any way entitle the candidate to be admitted to the school. Short listed candidates will be informed by e-mail / phone / post . Limited transport facilities are available on specific routes. Admissions therfore, will not automically ensure a seat in the school bus. INSTRUCTIONS : Please submit the following along with form Passport size photograph of the child and the parents duly affixed. A photocopy of the Birth Certificate issued by the Municipal Corporation / Civic Authorities. A photocopy of the latest progress report card. CERTIFICATE FROM PARENTS : I hereby certify that to the best of my knowledge the information given above is correct, I clearly understand that the school on accepting the registration form of ward is not in any way, obliged to grant admission. I also agree that the decision of the Principal regarding admission will be final and binding on me. Date Signature of Mother Signature of Father Signature of the Principal