DELHI PUBLIC SCHOOL, BANGALORE NORTH Survey No. 35/A, Sathanur Village, Jala Hobli, Bangalore-562149 Karnataka, India Tel: 28478041/42, Fax: 28478844 north@dpsbangalore.net / www.dpsbangalore.net REGISTRATION FORM Class XI 2015-2016 Please affix Recent passport size photo Registration No: One learn. No Office Use only Receipt Date: ISSUE OF REGISTRATION FORM DOES NOT ENSURE ADMISSION Name of Student: (Block Letters) Male / Female (tick) Date of Birth (dd/mm/yyyy ): (in words)_ Permanent Address: Pin code: Phone / Mobile No (s) : Preferred mobile no for SMS E-mail ID:- Father s Mother s Religion: Please Tick Appropriate Box: SC ST OBC Gen Blood Group: _ Nationality Mother Tounge Previous School Details: Name of School Address of School Affiliated to CBSE/any other Board (Please specify)
Medium of Instruction Proficiency in Sports/Music/Arts/NCC/NSS/others (Achievement in only last two years) (Please enclose copies of certificates awarded) * Grade obtained in the S. A. (I) / Pre Board Examination CBSE Schools No. Subject Grade Grade Point No. Subject Grade 1 4 Grade Point 2 5 3 6 ** Marks & % obtained in Mid-term / Pre-Board Examination ICSE / State / IGCSE No. Subject Marks % No. Subject Marks % 1 4 2 5 3 6 (** Students who have studied in schools not affiliated to CBSE may enter marks and % obtained) Science stream Compulsory Physics, Chemistry, Maths, English Optional subjects Computer Science/ Biology / Economics / Physical Education* Commerce Stream Compulsory - Accountancy, Business Studies, Economics, English Optional subjects Multimedia / Psychology / Maths / Entrepreneurship / Physical Education* Arts stream Stream 1 Compulsory - Psychology, Economics Political Science, English Optional subjects Multimedia / Maths / Physical Education* Stream 2 Compulsory - History, Economics Political Science, English Optional subjects Psychology / Multimedia / Maths / Physical Education* *Physical Education will be offered only if minimum of 5 students per stream is admitted.
Details of Parents Areas in which you could contribute to enrich school life in terms of time, skill, etc, (Please Tick) Others: Cultural Medical Media Professional Sports Academic Please fill in the following information Particulars Father Mother Name Academic Qualification (Please specify) University Designation Occupation: Details to be mentioned Business/Professional Self Employed Corporate Sector Govt.Service/Defence If Business: Shop/Factory/Industry If Professional: Architect/Doctor/Engineer Computer Engineer/CA Management/Services If Corporate: Multinational/National Name of Organization/Company Office Address & Phone Nos. Email ID Kindly fill whichever is applicable to you. Are you an ex-student of DPS? If yes, mention branch In case of staff child, name of the parent working at DPS : Details of siblings (real brother or sister) studying in DPS Bangalore
INSTRUCTIONS * Copies of marks card and CCE card to be submitted. * School leaving certificate in original has to be submitted. * Migration certificate in original for students who have migrated from any other board other than CBSE. CERTIFICATE I fully understand that the school on accepting the registration of my ward is not in any way bound to grant admission as the admissions are purely on the availability of seats & on qualifying pre admission test /interview. I also understand that the decisions of the Principal regarding admission will be final & binding on me. In the event of my ward being selected for admission, I shall have no objection to the school medical officer inoculating my child against typhoid A, B & cholera. I further undertake to abide by the school rules. I here by certify that the information given by me is correct & I shall abide by the decisions of the school. Note: The school provides transport facilities but offers no guarantee that a seat in the school bus will offered. When the buses are full to capacity/do not ply in the area of your residence, it will be the responsibility of the parents/guardians to drop & collect their ward from the specified bus stops. Transport once provided will not be discontinued during the academic session. Is School transport required: Yes No A sum of Rs. 600/- (non-refundable) to be paid via bank draft drawn in favor of DPS Bangalore North. Name of the student & Father s name to be clearly stated at the back of the bank draft. Date: Signature of Mother Signature of Father
XI Std Admission Details Science stream Compulsory Physics, Chemistry, Maths, English Optional subjects Computer Science/ Biology / Economics / Physical Education* Commerce Stream Compulsory - Accountancy, Business Studies, Economics, English Optional subjects Multimedia / Psychology / Maths / Entrepreneurship / Physical Education* Arts stream Stream 1 Compulsory - Psychology, Economics Political Science, English Optional subjects Multimedia / Maths / Physical Education* Stream 2 Compulsory - History, Economics Political Science, English Optional subjects Psychology / Multimedia / Maths / Physical Education* *Physical Education will be offered only if minimum of 5 students per stream is admitted. Selection Procedure is as follows: Students will have an entrance test on 1 st April 2015 at 9.00 am o Students opting for Science Stream will have a test in Maths & Science o Students opting for commerce stream (with or without Maths) English & Maths o Humanities (with Maths) will have a test in Maths & English o Humanities without maths will have test in English Entrance test will be based on NCERT Syllabus of class IX & X Students will appear for an MCQ based paper for Maths & Science. The English question paper will be descriptive in nature. Entrance test result will be declared on by 6 th April 2015 Provisional Admission for selected Candidates will be granted by April 10, 2015 & it will be confirmed after declaration Board Exam Results. School will start in the last week of May 2015.