Page 6 - School Diary 2022-2023

Permanent Address as per
Passport

Alternative Emergency No.

Residential Address :

Way No. Building No. Flat No.
Locality

Particulars of Brothers / Sisters in the School

G R No. Name Class & Sec

Mode of Transport for the Student :
( Tick on the appropriate box )

1. School Bus 2. Vehicle Driven by the Parent
3. Picked up by Driver / Friend / Relative 4. Company’s Vehicle

5. Private Bus 6. Travel on Foot

Any ailment / allergy / previous medical history

We have read all the rules and regulations given in the diary. We hereby promise to abide by them.

Father’s Signature Mother’s Signature
2