Eureka Admission form

EUREKA RESIDENTIAL SECONDARY SCHOOL
Laxmi Sadak, Dharan, Sunsari
Student's Details:
Name of Student*
First NameMiddle NameLast Name
Upload the image of Student
Browse Files
Recent taken PhotoCancelof
Admission to Class*
For Aademic session of*
Birth Date (B.S)*
dd/mm/yyyy
Birth Date (A.D)*
dd/mm/yyyy
Age*
Gender*
MaleFemale
School last attended (if applicable) :
Class
Sports/Games:
Ailment (If any)
Internet access at home*
YesNo
Parent's Details:
Father's name *
First NameMiddle NameLast Name
Mother's name *
First NameMiddle NameLast Name
Occupation
Address*
Street
Local Address
CityState
Tole
Contact Number*
NepalMobile number
Email
example@example.com
Local Guardian (If Any)
First NameLast Name
Phone Number
Area CodePhone Number
Address
DECLARATION
I hearby promise to obey and abide by all the school's rules and regulations along with any alterations as may be made therein by the management. I further promise to pay all the scholl fees and abide by the terms of admission and medical care in particular as per the prospectus.
I agree to above Declaration*
YesNo
Note:
Because of the current situation, I agree to accept that this form is subject to alteration and if required by the management will be able to submit the required documents physically.
I agree to above note*
YesNo
Should be Empty: