Pakshalika High - path to excellence

Student Enquiry Form

Name of the Child*

Gender*

Date of Birth*

Age on April 1

Grade in which admission is sought*

Special Needs (if any)

Current School (If applicable)

Father's Name

Occupation

Email ID

Mother's Name

Occupation

Email ID

Address

Father's Designation

Mobile No.

If you were referred by a friend, please let us know who so we can thank them

Behind Padmadhar Chaliha Statue, Melachakkar Tiniali, Sivasagar, Assam 785640

+91 3772 232323

info@pakshalikahigh.com

admin@pakshalikahigh.com

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