ST.

ANTHONY HIGH SCHOOL,

JUNIOR K.G. ADMISSION FORM ,
Student
2019-2020 Photo
.

Form No : 1168
Student's Details:

Name KHAN ZAARA SHAMSHIR TABASSUM

(Surname) (Student's Name) (Father's Name) (Mother's Name)
Date Of Birth 08-05-2015(Eight May Two Thousand and Fifteen)
Place of Birth PUNE PUNE PUNE Maharashtra
(Village) (Town) (District) (State)
Mother Tongue Hindi Gender Female
Religion Islam
Caste Muslim Sub Caste Sunni
Nationality INDIAN Mobile No 9860834454
Father's Residential Address 2170 New Modhikhana, Poolgate, Camp Pune
Mother's Residential Address 2170 New Modhikhana, Poolgate, Camp Pune
Distance from 1-2 Kms
School

Parents Details:

Information About Father Mother

Religion Islam Islam
Educational Qualification HSC Ssc
Name & Place of School St. Anthony School Netaji School
Attended
Name & Place of College Poona College None
Attended
Nature of Occupation Business Housewife
Mobile Num 9860834454 9860834454
Office Address 2148 New Modhikhana, Nil
Poolgate, Camp Pune
Whether Ex student of St Yes No
Anthony
If Yes, Class & Year of VII 1992 NA
Passing

Sibling Details:

Name Class Relation

Mohammed Khan VII
Abdullah's Khan V
AbdulRehman Khan UKG
I declare that all the above information is true and accurate.
Date : Signature of Parent / Guardian :
SCHOOL COPY

Form No.: 1168

ST. ANTHONY HIGH SCHOOL

L.Kg 2019-2020
Acknowledgement Slip

Full Name of the Candidate :KHAN ZAARA SHAMSHIR TABASSUM

This is to acknowledge that we have received your child's admission form.

School Stamp with Signature.

........................................... ...........................................

Signature of Parents Signature of Guardians

(If Applicable)

.....................................................................................................................................
PARENT'S COPY

Form No.: 1168

ST. ANTHONY HIGH SCHOOL

L.Kg 2019-2020
Acknowledgement Slip

Full Name of the Candidate :KHAN ZAARA SHAMSHIR TABASSUM

This is to acknowledge that we have received your child's admission form.

School Stamp with Signature.

........................................... ...........................................

Signature of Parents Signature of Guardians

(If Applicable)