Application No *
Admission No *
First Name
Last Name
Date Of Birth *
Gender Male Female
Religion *
Caste * SC ST OBC Others
Blood Group *
Upload Passport Photo Copy
Nationality
Mother Tongue
Name of Father *
Residential Address
Educational Qualification *
Occupation * Business Employed
If employed, Employer's Name *
Mobile Number *
E-mail ID *
Name of Mother *
Name & Address of Local Guardian : (if any) *
Mobile *
Email *
Brother *
Age *
Sister *
Name & Address of previous school/s attended with duration : *
Reason for leaving the previous school : *
Is there evidence of learning disability ? If YES, please furnish full details : *
General Health : Does the child suffer from any allergies or has a history of asthma, epilepsy, diabetes, physical disability or other illness ? If YES, Please furnish full details : *
Sports, Games & Other Activities interested in *
Hobbies *
Details of any relatives and/or siblings studying in Green Dot International School and its other branches : *
DPT, OPV I Booster * YES NO
Hepatitis B * YES NO
Hepatitis A * YES NO
Typhold * YES NO
Name any serious illness suffered with date : *
Any physical disability / learning difficulty : *
Languages the child can speak/understand: *
When did your child : Crawl?
When did your child : Walk?
Comprehend ? * YES NO
Communicate (Talk) ? * Yet to begin Words Sentences
Maintain eye contact ? * YES NO
Concentrate ? * No Short Time Longer Time
Throw Temper Tantrums If YES, how do you manage * YES NO
Work with Puzzles ? * YES NO
Watch T.V. ? * YES NO
If YES, Which Channel & Duration ?
Is he / she toilet trained ? * YES NO
Does he / she have any allergies ? * YES NO
If YES, please specify ?
Has your child attended a play - school / creche before ? * YES NO
If YES, name and duration
If both parents work, who takes care of the child in absence of parents ?
Is your child friendly with other children ? * YES NO
Does your child share his / her toys with other children ? * YES NO
Does he / she harm other children while playing ? * YES NO
If YES, do you correct him / her ? * YES NO