Pioneer Convent School

KASHIPUR, JAGARDEVPUR, VARANASI
Varanasi, INDIA-221311
Tel: +91 9918235808 | Email: pcsdurga123@gmail.com

Registration Form (2020-21)

Note: All ‘*' marked fields are mandatory. Please mention 'NA’ if not applicable.
 
 

Student Details:

 
Student First Name*
Middle Name
 
Last Name*
Gender*
 
Blood Group
Date of Birth*
 
Category *
Mobile No. *
 
Nationality*
Caste*
 
Mother Tongue
Religion*
 
Previous School*
Previous Class*
 
Admission Sought in Class*
Student's Aadhar Card No.
 
Kindly Subject Stream For Class XI
Address*
 
Pincode*
Student E-mail
 
Student's Photo*
 
 

Father Details:

 
Name*
Academic Qualification*
 
Occupation*
 
Residential Address*
E-mail
Mobile No.*
 
Annual Income
 

Mother Details:

 
Name*
Academic Qualifications*
 
Occupation*
Mobile No.
 

Additional Information

 
Do you want to need transport *
If transport facility is not available, would you still seek admission *
 
I Agree