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First name *

Last name *

School Name *

Date of Birth *

Grade ( As per Academic Year 2025-26) * Grade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8Grade 9Grade 10Grade 11Grade 12

Parent Name *

Street address ( At this address your Certificate and Medal will dispatch) *

Apartment, suite, unit, etc. (optional)

Town / City *

State / County * Select an option…Andhra PradeshArunachal PradeshAssamBiharChhattisgarhGoaGujaratHaryanaHimachal PradeshJammu and KashmirJharkhandKarnatakaKeralaLadakhMadhya PradeshMaharashtraManipurMeghalayaMizoramNagalandOdishaPunjabRajasthanSikkimTamil NaduTelanganaTripuraUttarakhandUttar PradeshWest BengalAndaman and Nicobar IslandsChandigarhDadra and Nagar HaveliDaman and DiuDelhiLakshadeepPondicherry (Puducherry)

Postcode / ZIP *

Phone *

Email address *