MILESTONE EDUCATION SOCIETY, PEHOWA
No.MSES01/ /……………………
STUDENT ADMISSION-FORM
Name of the Student :…………………………………………………………
Mother’s Name :……………………………………………................
Father’s Name :………………………………………………………… PHOTO
Date of Birth :…………………………………………………………
Caste & Category :…………………………………………………………
School :……………………………………………………………………….
Class……….……………………………Roll No..……………….....
Home Address :………………………………………………………………………..
………………..……………………………………………………….
…………………..…………………………………………………….
Phone/Mobile No………………………………….............…….
Declaration:
It is hereby stated that the above information is true .
Date;
Place: (Signature)
Parents/Guardian
Note: Kindly submit the form after completing it to the Society Address in following Address:
Milestone Education Society (Regd.002),
Balmiki Dharamshala, Balmiki Basti,
Pehowa-136128, Distt. Kurukshetra (Haryana)