Laxmi Narain Verma Memorial Society
(H 974, Palam Extn., Part. 1, Sec.7, Dwarka, New Delhi 77.)
ONLINE STSE 2010 ENROLLMENT FORM
Student Personal Information
Name Of The Student
Name Of The Father
Sex
Male
Female
Date Of Birth
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
January
February
March
April
May
June
July
August
September
October
November
December
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
E-Mail
Nationality
Indian
Other
Address
State
Andra Pradesh
Arunachal Pradesh
Assam
Andaman and Nicobar Islands
Bihar
Chhattisgarh
Chandigarh
Dadar and Nagar Haveli
Daman and Diu
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Lakshadeep
Madya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Orissa
Punjab
Rajasthan
Sikkim
Tamil Nadu
Tripura
Uttaranchal
Uttar Pradesh
West Bengal
Phone Number
Mobile Number
Student 's School Information.
Name Of The School
Name Of The Principal
Address Of School
State
Andra Pradesh
Arunachal Pradesh
Assam
Andaman and Nicobar Islands
Bihar
Chhattisgarh
Chandigarh
Dadar and Nagar Haveli
Daman and Diu
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Lakshadeep
Madya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Orissa
Punjab
Rajasthan
Sikkim
Tamil Nadu
Tripura
Uttaranchal
Uttar Pradesh
West Bengal
School Phone Number
Mobile No. Of Principal
Misc/Other Information.
Edu. Qualification
10+2(PCM)
10+2 (PCB)
10+2 (Arts)
10+2(Commerce)
Enrolled For
ATC
ANTC
PMC
HMC
DD Amount.
Medium
English
Hindi
DD Number.
By Bank.