Open Minds Bhagalpur
HealthEra

OPEN MINDS

BHAGALPUR

Dear Parent

Thank you for showing interest in our school. To register for the orientation program, kindly fill in the details below and our representatives will get in touch with you for the confirmation.

Student's Details
* Indicates mandatory fields.
Seeking admission for student: *
Name of the student : *      *
First NameMiddle NameLast Name
Date of birth [DD/MM/YYYY] :
* Gender :
*
Seeking admission for grade: : *
Application for academic year : *
Present school :
Present school affiliated to :
(Board)
Current address : * Permanent address : *
Permanent Address Same As Current Address
Parents' Details
Father's name : *
Mobile number : *
Email id : *
Qualification :
Occupation :
Name of the organization :
Designation :
Mother's name : *
Mobile number :
Email id :
Qualification :
Occupation :
Name of the organization :
Designation :
Other Details
No. of siblings :

Reason for change of school : *
Special needs if any :
How did you hear about us :
*