ADMISSION TO:
La Martiniere for Boys------------- La Martiniere for Girls

 
NAME:
---(as given in the Municipal Corporation Birth Certificate / Baptism Certificate)
 

 

DATE OF BIRTH:
(as in the Municipal Corporation Birth Certificate/Baptism Certificate)between 1st January 2016 - 31st December 2016
 

(DD/MM/YYYY)

 

 

--Please Specify if: -

- ----------------------------------------- Married ----------- Divorced ---------- Separated ---------- Single Parent


--DETAILS (FATHER)

---NAME: - DATE OF BIRTH: (DD/MM/YYYY)

--DETAILS (MOTHER)

---NAME: - DATE OF BIRTH: (DD/MM/YYYY)

 

----HOME ADDRESS : ------E-MAIL ID ---:

 

----PHONE NO/S : -- -REGISTER MOBILE NO FOR ALERTS AND UPDATES:

 

 

 

Prescribed Format, only avilable at lamartiniere.co

 

 

             
 

--Child's

--Passport Size Photograph (JPG FILE)

uploaded image preview

Father's

Passport Size Photograph

(JPG FILE)

uploaded image preview

Mother's Passport Size Photograph

(JPG FILE)

uploaded image preview

 

I HEREBY DECLARE THAT THE INFORMATION PROVIDED IN THIS FORM IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE

 

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