Note: (1) If any of the particulars given below are found incorrect or incomplete the Application for admission will be rejected. (2) KINDLY FILL THE FORM IN BLOCK LETTERS ONLY. Password:* Candidate's Name* Date of Birth* Year 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Nagar Mahapalika Birth Certificate No. Date Place Mother Tongue* Category* Select GENERAL OBC SC ST Anglo Indian Religion* Select Hinduism Islam Sikhism Christianity Buddhism Jainism Parish Nationality* Gender* Female Residential Address [Local]* H.No. * Locality* City* State* Pin Code* Contact No.* Name of The School Last Attended* Address of The School Last Attended* Last Examination Passed Year Medium of instruction Choose only two stream * ScienceCommerceHumanities Group AHumanities Group B Select Subject Science First priority English Physics Chemistry Group I Psychology Economics PHYSICAL EDUCATlON Group II Biology Mathematics Computer Science Hindi Home Science Commerce First priority English Accounts Commerce Group I Psychology Economics PHYSICAL EDUCATlON Group II Mathematics Computer Science Hindi Home Science Humanities Group A First priority English History Group I Psychology Economics PHYSICAL EDUCATlON Group II GEOGRAPHY ECONOMICS POLITICAL SCIENCE Group III HOME SCIENCE HINDI Humanities Group B First priority English History Group I Psychology Economics PHYSICAL EDUCATlON Group II GEOGRAPHY ECONOMICS POLITICAL SCIENCE Group III BIOLOGY MATHEMATICS COMPUTER SCIENCE Siblings(not cousins) studying in Loreto Convent Intermediate College, Lucknow Name Of Child Age Gender Class Female Female Female Father's/Guardian's Details Father's/Guardian's Name * Mr. Dr. Er. Late Academic Qualification* Category Select GENERAL OBC SC ST Anglo Indian Religion* Select Hinduism Islam Sikhism Christianity Buddhism Jainism Parish Occupation * Select Occupation Service Business Self-Employee N/A Dept./Organization Nature of Bussiness Designation Type of Bussiness Details of Employment Monthly Income* Home Address Office Address Mobile No.* Telephone No. Mother's/Guardian's Details Mother's/Guardian's Name* Mrs. Dr. Er. Late Academic Qualification* Category Select GENERAL OBC SC ST Anglo Indian Religion* Select Hinduism Islam Sikhism Christianity Buddhism Jainism Parish Occupation * Select Occupation Service Business Self-Employee Housewife N/A Dept./Organization Nature of Bussiness Designation Type of Business Details of Employment Monthly Income Home Address Office Address Mobile No. Telephone No. Mother's Maiden Name Year Of Joining Class Year Of Leaving Class Other Details Reason for seeking admission to this school (Character limit 250) Applicant Name* Applicant Email* Applicant Contact Number* Child's Photo*   [ Size upto 80 kb] Applicant Signatue*   [ Size upto 80 kb] Father Signatue   [ Size upto 80 kb] Mother Signatue   [ Size upto 80 kb] Declaration We hereby declare thet we are ready to abide by the decision with regard to admission by the school authorities. Verification Verified that the statements made and information furnished by me/us in the above registration form are true and correct to the best of my/our knowledge and nothing has been concealed there of and in case any information is found to be incorrect of withheld then I/we understand that admission if already made shall automatically stand cancelled.