Admission Form 

    All fields are mandatory

   Office Use Only:__________________________________________________________________

   Admission No: ______________ Serial: _____________ Date: _____________________________

   Admission For: 3 yrs, playgroup                   4 yrs, Nursery                    5 yrs, junior 

CHILD’S DETAIL:

   Name Of Child:________________________________________________________________________

                                   (First name)                              (Middle name)                                  (Surname)

   Date of Birth:_____/_____/________      in words:____________________________________________

                         (dd)    (mm)    (yyyy)              Gender: Male            Female                                       

   Place Of Birth: _______________________ Nationality_______________________________________

   Religion: ______________________________ Cast:__________________________________________

PARENT’S DETAIL:

   Father’s Name: ________________________________________________________________________

                                   (First name)                              (Middle name)                                  (Surname)

   Complete Address: ____________________________________________________________________

    _____________________________________________________________________________________

  CNIC No:______________________________ Contact No:_____________________________________

 Father’s Qualification (highest degree):_____________________________________________________

 Occupation: Business/Service/Self Employed/Any Other: ______________________________________

 Mother’s Name: __________________________ Contact No: __________________________________

 Name and contact detail of person in case of emergency: ______________________________________

 _____________________________________________________________________________________

 Why did you not admit your child earlier to ECD centre? _______________________________________

  _____________________________________________________________________________________

 Where did you come to know about this ECD centre?__________________________________________

 _____________________________________________________________________________________

 Does your child have any physical disability that needs to be taken care of? Yes           No           

  If Yes, Describe: ________________________________________________________________________

  PERMISSION:            I allow for the polio vaccination and health screening of my child at ECD center.

  _____________________________________________________________________________________

 

    _________________________                                                      ___________________________________

      (Principal Signature)                                                                              (Parent/Guardian Signature)