Application Form

Fields marked with * are mandatory.

*Application for:

General Information

I/We are considering enrolment in Grade/Class

With effect from

month/year

Personal Detail of Students

*Name of candidate:

*Date of Birth:

(YYYY-MM-DD)

*Gender:

Male Female

*Nationality:

*Mother Tongue:

*Residence Address:

*City/State:

*Country:

*Pincode:

Home Landline:

*Student Mobile:

*Email Address:

*Student Picture (jpg,jpeg,pdf)(5MB):

Educational Background

Name of current/pervious School attending/attended:

Parent's/Guardian's (Profession/Occupation) Information

*Father Name:

Email Id:

Father Mobile:

Father's Occupation/Profession:

Father Nationality:

Father Picture (jpg,jpeg,pdf)(5MB):

*Mother Name:

Email Id:

Mother Mobile:

Mother's Occupation/Profession:

Mother Nationality:

Mother Picture (jpg,jpeg,pdf)(5MB):

Are parents living together if not Please indicate position

Yes No

Student Resides with

Mother & Father Mother Father Guardian Stepfather Stepmother

Local Guardian's info

Guardian Name:

Guardian Occupation:

Guardian Nationality:

Guardian Mobile:

Guardian Email:

Guardian Picture (jpg,jpeg,pdf):

Other Relatives Information

Real Brother/Sister 1 Name:

School/College:

Real Brother/Sister 2 Name:

School/College:

Reference

(Detail of one person who can vouch for you not related to you)

*Reference Name:

Reference Occupation:

Reference Mobile:

Reference Residence Address:

Reference Pincode:

When and How did you first hear about GDGWS? Please Tick appropriate boxes

Present school Friends Internet Goenkan alumni Newspaper Others

Proficiency record

Please provide details, if any
Sports, Performing Arts (Music,Dance,Drama,Debates etc), Position of responsibility held in school or community, others

Learning profile

Have the student ever been tested for any of the following
Learning Difficulties: Yes No
Behavioural Difficulties: Yes No
Emotional Difficulties: Yes No
Physical Difficulties: Yes No

Have the student ever been tested for any of the following
If Yes, please describe

Transportation

School bus facility required

Yes No

Declaration

I/We certify that the information furnished in this form is true to the best of my knowledge and belief. False or incorrect information supplied in this application could lead to cancellation of admission.

Upload signature(jpg,jpeg,pdf)(5MB)

*Name in block letters

*Dated