SPRINGDALES SCHOOL Pusa Road, Upper Ridge Road Junction, New Delhi - 110005 Website : www.springdalespusa.com REGISTRATION FORM FOR ADMISSION TO PRE-SCHOOL CLASS (NURSERY) Under General Category and Staff Category 2023-2024 The admission software will automatically REJECT the form if filled for more than one Branch. Apply only to ONE Branch. 1. Name of Child: Gender: --Select gender-- Male Female Aadhaar Card Number of the Child (Optional): 2. Date of Birth: Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   Month January February March April May June July August September October November December   Year 2019 2020 (Copy of Birth Certificate to be submitted along with the form. Minimum age 2 years 11 months and Maximum age 4 years 1 month as on 31.03.2023, as per the age relaxation guidelines by DOE. Please refer to the admission policy. Click Here) 4. Name of Father: Age: 5. Name of Mother: Age: 6. RESIDENCE CRITERIA: 39 Residential Address: Telephone No: Mobile No (Father): Mobile No (Mother): Email ID (Father): Email ID (Mother): Children living in the areas as per the list of localities hereunder - East Patel Nagar, West Patel Nagar, Pusa Road, Prasad Nagar, W.E.A. Karol Bagh, Pusa Institute, Minto Road, North Campus, Shankar Vihar, Shankar Road, Old Rajender Nagar, New Rajender Nagar, Kirti Nagar, Ramesh Nagar, Rajouri Garden, Anand Parbat, Kasturba Gandhi Marg, Princess Park, Dhaula Kuan Army Flats, Arjun Vihar, Inder Puri / Naraina, Mukherjee Nagar, Maurice Nagar, Timarpur will get 39 points. Those applicants not living in the areas mentioned above will get 29 points. Kindly mention what proof of residence has been attached Voter I D (EPIC) of any of the parents Domicile certificate of the child or his / her parent Electricity Bill MTNL telephone bill Water Bill in the name of parent Passport in the name of any one of the Parent or child Aadhaar Card / UID card issued in the name of any of the parents 7. SIBLING CRITERIA (REAL BROTHER / SISTER ONLY) 35 If sibling is in Springdales School, Pusa Road, give details:   --Select-- Yes No SIBLING ADMISSION NO.: Sibling Name: Class: Select option Nursery Prep I II III IV V VI VII VIII IX X XI XII Section: Select option A B C D E F Branch: Select option Pusa Road (Enclose a copy of fee bill / report card along with the form. Irrespective of the branch of the first child no inter unit transfers will be allowed at any stage.) There will be no points given in the Sibling Criteria if the older Sibling is studying in Springdales School, Dhaula Kuan or is a cousin of the child seeking admission. 8. Do you have any children studying in any other school ? If so, kindly specify. Name of Real Brother / Sister Age School Attending / Attended 9. SCHOOL ALUMNI 26 Is the applicant parent a former student of Springdales  Select option Yes No A) Former students who have been in the school for 11 years and above and have a Character Certificate, will get 26 points. (Kindly attach a copy of the Character Certificate). B) Former students who have been in the school for 5 years upto 10 years will get 16 points. (Kindly attach a copy of the Mark-sheet of Class X and School Leaving Certificate). C) Former students who have been in the school for less than 5 years and have become a members of the Old Springdalians Association, will get 11 points. (Kindly attach a copy of the Character Certificate and copy of OSA Membership Card). If yes, year of Passing OSA Membership No Unit (A) Father Select option Pusa Road Dhaula Kuan (B) Mother Select option Pusa Road Dhaula Kuan In case of Springdalian Mother, give maiden name. In case you are a life member of the Old Springdalians Association, kindly give your Membership No. and Year of Membership (for school database only). Total Number of years spent in Springdales School including all Units (in case you have taken inter unit transfer) Kindly attach proof: Attach as proof - Copy of OSA Membership Card, Character Certificate, School Leaving Certificate, copy of Mark-Sheet of Class-X as relevant to clauses A, B & C. Only the above will be considered for admission under the Alumni Criteria. 10. STAFF CATEGORY: (No Points) As per the Circular of Directorate of Education Dated: 26-11-2018 SL. No. 6 of admission criteria: ''The ward of Staff / Employees of any school concerned can have a right for admission to that school but extending the same benefits to the sister concern of that particular school will curtail the right of General Parents' wards'' As per the clause quoted above confirmed and permanent staff members with children / grandchildren can only apply in the branch of the school where they have served / are serving. The application will be rejected if applied for in any other branch. Only Children of staff members who are confirmed and permanently employed in the Institutionare eligible. Grandchildren of Staff members who have attained Superannuation are also eligible. Kindly give details of employment in the school - branch, position, date of employment and years of service and an affidavit stating that the applicant is the grandchild of the staff member Is the applicant parent / grandparent an employee of the school ? Select option Yes No If yes, details of employment in the school Will be admitted to a maximum of 5% seats under Staff Category. Unfilled seats will be converted to General Category. INFORMATION ABOUT PARENTS FOR SCHOOL DATABASE ONLY (Please Note : There is no allocation of points in this section) EDUCATIONAL QUALIFICATION AND OCCUPATION OF PARENTS: Please write N/A if field not applicable. FATHER: Father's Qualification: Schools/Colleges attended by father: Profession/Occupation of father: Office Address and Telephone Nos. of Father: MOTHER: Mother's Qualification: Schools/Colleges attended by mother: Profession/Occupation of mother: Office Address and Telephone Nos. of Mother: PLEASE NOTE: The points calculated on the registration form submitted online are subject to verification and may change. This is an application for registration only. Those parents short-listed for verification of documents will be informed by phone/website. There will be no points given in the Sibling Criteria if the older sibling is in Springdales School, Dhaula Kuan or is a cousin of the child seeking admission. NO inter unit transfers will be allowed at any stage. Copy of Municipal Birth Certificate, Proof of residence and other required documents are to be submitted by parents along with the form. Please fill up this form very carefully as information given herein will be considered for the admission of your child. Only ONLINE Payment of registration fee will be accepted. If the hard copy of the form duly filled is not submitted to the respective Branch along with the receipt of the registration fee of Rs.25/-, paid ONLINE, the form will be DISQUALIFIED. The admission software will automatically REJECT the form if filled for more than one Branch. Apply only for One Branch i.e Pusa Road / Dhaula Kuan. Kindly attach a copy of the Aadhaar card of the child and parent. This registration form is for admission to Pre-School Class only. 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