student profile form

5
STUDENT PROFILE Student details 1. Name of the Student : ____________________________ 2. Gender (Male, Female, Others) : ____________________________ 3. Class and Year : ____________________________ 4. Admission Number : ____________________________ 5. Date and year of admission : ____________________________ 6. Blood Group :____________________________ 7. Category : ____________________________ 8. Date Of Birth : ____________________________ 9. Aadhaar card number :_____________________________ 10. Parent’s E-Mail Id :_____________________________ 11. Mother tongue :_____________________________ 12. Language spoken at home by your child and yourself : ___________________ 13. SC/ST/OBC/Gen :_____________________________ 14. Religion : _____________________________ 15. Whether differently abled :______________________________ 16. Nationality :______________________________ 17. Home town address :______________________________ 18. Siblings (If any) :______________________________ 19. Details of siblings studying in this KV: S.No Name of the student Class and section 20. Field of interest / Expertise of the child: AFFIX PASSPORT SIZE PHOTO

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Page 1: Student Profile Form

STUDENT PROFILE

Student details

1. Name of the Student : ____________________________

2. Gender (Male, Female, Others) : ____________________________

3. Class and Year : ____________________________

4. Admission Number : ____________________________

5. Date and year of admission : ____________________________

6. Blood Group :____________________________

7. Category : ____________________________

8. Date Of Birth : ____________________________

9. Aadhaar card number :_____________________________

10. Parent’s E-Mail Id :_____________________________

11. Mother tongue :_____________________________

12. Language spoken at home by your child and yourself : ___________________

13. SC/ST/OBC/Gen :_____________________________

14. Religion : _____________________________

15. Whether differently abled :______________________________

16. Nationality :______________________________

17. Home town address :______________________________

18. Siblings (If any) :______________________________

19. Details of siblings studying in this KV:

S.No Name of the student Class and section

20. Field of interest / Expertise of the child:

AFFIX

PASSPORT SIZE

PHOTO

Page 2: Student Profile Form

a. ______________________________________________________

b. ______________________________________________________

c. ______________________________________________________

21. Ambition of the student: __________________________________________________

22. Does the child attend any skill enhancement classes: ____________________________

23. Special awards or recognitions attained by the student:

_________________________________________________________________________

_________________________________________________________________________

24. Whether a part of Cubs / Bulbuls - ________________________________________

25. Medical history (if any)

_________________________________________________________________________

_____________________________________________________________________

26. Allergies - such as any specific food, dust etc (if any please specify)

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

27. Mode of student conveyance to school – (Self/Parent/Auto/Cab/Van/Others)

a. Vehicle number: ___________________________________________________

b. Driver’s name and contact number: ____________________________________

28. Whether the child stays

Page 3: Student Profile Form

(With Mother alone/Father alone /Both Mother & Father /Grandparents/Grandparents

and Parents/Guardian)

Parent details

42. Whether single issue (Yes/No) : ____________________

43. Whether they have only girl child (Yes/No) : ____________________

29.Father’s name :________________________

30.Qualification :________________________

31.Age :________________________

32.Occupation :________________________

33.Work place : _______________________

34.Basic Pay :________________________

35.SC/ST/OBC/Gen :________________________

36.Office Address :________________________

_______________________________________

______________________________________

37.Permanent address:_______________________

_______________________________________

_______________________________________

38.Local Address:___________________________

_______________________________________

_______________________________________

39.Contact No :________________________

40.Blood Group :________________________

41.Field of interest :________________________

Mother’s name :_________________________

Qualification :_________________________

Age :_________________________

Occupation :_________________________

Work place : ________________________

Basic Pay :_________________________

SC/ST/OBC/Gen :______________________

Office Address:_________________________

___________________________________

___________________________________

Permanent Address:______________________

___________________________________

___________________________________

Local Address:__________________________

___________________________________

___________________________________

Contact No : _____________________

Blood Group : _____________________

Field of interest : _____________________

Page 4: Student Profile Form

44.Any other point you would like to mention about the child’s behavior:

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

To be filled by the Class Teacher

45.Portfolio held by the student

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

46.Participation in co-curricular and sports activity and position (if any)

S.No Name of the competition Position held

Remarks:

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Page 5: Student Profile Form

SIGNATURE OF THE FATHER SIGNATURE OF THE MOTHER

SIGNATURE OF THE CLASS TEACHER SIGNATURE OF THE HEAD MISTRESS

SIGNATURE OF PRINCIPAL

AFFIX FAMILY PHOTO