Students Registration form for "THE PATRIOTS" awards

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Name of Child *

Please write First & Last name of child as mentioned on School's Identity Card. For Example: Rahul Bhartiya

Sex *

Date of Birth (MM/DD/YYYY) month/date/year *

For Example: 06/15/1980 (please use same format, else registeration will not be considered)

As per date of birth, age is *

Any child who is less then 12 years OR more than 18 years w.e.f. from 1-April-2012 is not eligible for participation

School Name *

If the name of your school is not mentioned in the list, then select "other" and fill the details of your school in options provided below.

Name of school in which studying, if your school name is not present in the above list

Please don't fill short form of school name (not allowed). Please mention full name of School. For Example: Carmel Convent School

Sector in which school is located, if your school name is not present in the above list

Please mention in numeric letters only. For example: 18

Class *

Section *

Roll Number *

Father's Name *

Please write full name. For Example: Satya Kumar Gupta

Current Living Address *

Sector *

City *

Only Chandigarh residents are eligible.

Personal Mobile Number *

only write 10 digit number. For Example: 9000900090.

Father's Mobile Number *

only write 10 digit number. For Example: 9000900090

Mother's Mobile Number *

If your mother doesnt have a mobile number, then write the mobile number of your father/brother/sister

Personal Email id *

please write email id in small letters. For Example: rahul.bhartiya@rahulbhartiya.com

Father's/ Mother's Email id *

please write email id in small letters. For Example: rahul.bhartiya@rahulbhartiya.com

Would you like to nominate your name for "Keep the cause alive" special award? *

If you have chosen the option"Yes", then make sure that you start the activity from 1st June and continue till 30th June. If your Power Point presentation won't have all the 30 pictures of different days, then your nomination will not be considered.

Yes

Required

Would you like to nominate your name for "Best Project Report" special award? *

If you have chosen the option"Yes", then make sure that your Project Report carry all the details from 1st June and continue till 30th June.

Yes

Required

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