Online Registration

PSBB Learning Leadership Academy
No. 52, Laxmipura Sahasra Deepika Road, Off. Bannerghatta Main Road
Bangalore KAR 560083

Registration Form

Academic Session 2024-25

Parents are requested to note:

* implies mandatory fields

Name of the Child (as per Birth Certificate) ^*

Gender ^*

Date of Birth ^*

(between 01/Dec/2007 to 01/Jun/2021)

Age as on 01/Jun/2024

Staff Child

Mother Tongue ^*

Religion ^*

Caste ^*

Nationality ^*

Aadhaar No.

Class to which admission is sought: ^*

School last attended (if any)

Last class attended

Medium of Instruction

Language preferences: (applicable from Class I onward)

Language 1

Language 2

Parent Information

Mother

Father

Name ^*

Date of Birth ^*

Education ^*

Mobile Number ^*

Email ^*

Aadhaar Card No.

Please specify the following (if applicable)

Occupation ^*

Designation

Name of the Organization

Office Address

Annual Income (in Lacs)

Marital Status ^*

Residential Address

Residential Address ^*

PIN Code^*

City ^*

State ^*

Residential Phone No. (s) ^*

Emergency Phone No. (s) ^*

Email for communication with school for admission ^*

Other Details

Distance to School from Residence^*

Mode of Transport ^*

Does your child have any major ailment/allergy? ^*

If "YES", please specify

Sibling in School

If "Yes/Applied", then please specify the name of sisters and brothers in chronological order (oldest to youngest)

	Name	Age	Gender	Class/Sec	Admission Number / USN / STS Number
a
b
c
d

This is to certify that the facts given by me on the registration form are true. I understand that if any part of it is found to be false, this registration will be cancelled.

PSBB Learning Leadership Academy No. 52, Laxmipura Sahasra Deepika Road, Off. Bannerghatta Main Road Bangalore KAR 560083

Registration Form

Parent Information

Residential Address

Other Details

PSBB Learning Leadership Academy
No. 52, Laxmipura Sahasra Deepika Road, Off. Bannerghatta Main Road
Bangalore KAR 560083