Loyola International School Gomti Nagar

1. Name (in block Letters)

2. Father's Name

3. DOB Gender

4. year of Admission Branch

5. Year of Passing

6. Email

7. Mobile No

8. Residence Address

9. Present Organization where working

Present Employment Details	Organisation Name	Address	Designation

10. Information of three batch mates

Name	Course	Email-ID

11. Special Achievements

Place Date

Signature

*(The filled form may be send as email attachment at loyolaischool@gmail.com)

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