Downloaded & Printed

Recent
passport-size
Brigade Gateway Enclave, No. 26/1, Dr. Rajkumar Road, photograph of the
Malleswaram West, Bangalore - 560 055. student to be
Contact: 91-80-4141 1581 / 6568 2437 pasted here.
www.brigadeschools.org

Application Form DATE: _______________________________

Admission required for:

NURSERY LKG UKG STD 1 STD 2 STD 3

STD 4 STD 5 STD 6 (HIGHER STDS WILL BE ADDED PROGRESSIVELY)

PLEASE USE CAPITAL LETTERS ONLY. WHEREVER BOXES ARE PROVIDED, MARK YOUR CHOICE WITH A “ ” INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED

A. PERSONAL DATA

FULL NAME OF THE STUDENT ...........................................................................................................................................................................................…………………..  MALE  FEMALE

(As it should appear in official school certificates)

DATE OF BIRTH
(No alteration will be allowed)
DATE MONTH YEAR

NATIONALITY.............................................................................. RELIGION............................................................................ MOTHER TONGUE.................................................................................

DOES THE STUDENT BELONG TO SCHEDULED CASTES, SCHEDULED TRIBES OR B.C. AS PER GOVT LIST?  NO  S.C.  S.T.  B.C.
_______________________________________________________________________________________
NAME OF FATHER ........................................................................................................................................................................... QUALIFICATIONS .............................................................................

OCCUPATION, ORGANISATION & OFFICE ADDRESS ...............................................................................................................................................................................................................................

............................................................................................................................................................................................................. OFFICE PHONE ...............................................................................

MOBILE ....................................................................................................................................... E-MAIL ..................................................................................................................................................

_______________________________________________________________________________________
NAME OF MOTHER ............................................................................................................................................................................. QUALIFICATIONS .........................................................................

OCCUPATION, ORGANISATION & OFFICE ADDRESS ..............................................................................................................................................................................................................................

................................................................................................................................................................................................................ OFFICE PHONE …........................................................................

MOBILE ....................................................................................................................................... E-MAIL .................................................................................................................................................

_______________________________________________________________________________________

PARENTS’ RESIDENTIAL ADDRESS ...........................................................................................................................................................................................................................................................

.........................................................................................................................................................................................................................................................................................................................

............................................................................................................................................................... RESIDENCE PHONE ..............................................................................................................

_______________________________________________________________________________________
ANNUAL INCOME: FATHER’S: Rs. ........................................................................................... MOTHER’S: Rs. .......................................................................................................................

_______________________________________________________________________________________

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 STUDENT’S NAME ..................................................................................................................

NAME OF GUARDIAN ............................................................................................................................................................................ QUALIFICATIONS .......................................................................

(If applicable)
OCCUPATION, ORGANISATION & OFFICE ADDRESS ...............................................................................................................................................................................................................................

..........................................................................................................................................................................................................................................................................................................................

..................................................................................................................................................................................................................... OFFICE PHONE ........................................................................

MOBILE............................................................................................................................................. E-MAIL...........................................................................................................................................

GUARDIAN’S RESIDENTIAL ADDRESS .......................................................................................................................................................................................................................................................

..........................................................................................................................................................................................................................................................................................................................

RESIDENCE PHONE ..............................................................................................................................ANNUAL INCOME: Rs...................................................................................................................

_______________________________________________________________________________________
DETAILS OF BROTHERS / SISTERS OF THE STUDENT

NAME AGE INSTITUTION STUDYING IN STANDARD

BLOOD GROUP: ……………………………………

DOES THE STUDENT HAVE A MAJOR AILMENT / ALLERGY THAT THE SCHOOL SHOULD KNOW ABOUT?...................................................................................................................................…

........................................................................................................................................................................................................................................................................................................................

…......................................................................................................................................................................................................................................................................................................................

_______________________________________________________________________________________
B. DETAILS OF PREVIOUS STUDY

1. NAME AND ADDRESS OF THE SCHOOL / PLAYSCHOOL IN WHICH THE STUDENT LAST STUDIED .............................................................................................................................................

.............................................................................................................................................................................................................................................................................................................……

2. STANDARD STUDYING IN AT PRESENT .....................................................................…………. MEDIUM OF INSTRUCTION .............................................................................................………

3. WHETHER QUALIFIED FOR PROMOTION?  YES  NO IS THE PREVIOUS SCHOOL AFFILIATED TO: SSLC CBSE ICSE  OTHER

4. STANDARD INTO WHICH ADMISSION IS NOW SOUGHT......................................................................................................................................................................................................................

5. LANGUAGES THE STUDENT HAS PREVIOUSLY STUDIED: SECOND LANGUAGE: ……………………………………………… STUDIED FROM STD …………………………………………..

THIRD LANGUAGE:……………………………………………………… STUDIED FROM STD …………………………………………..

6. IF ADMITTED, WHAT LANGUAGE WILL THE STUDENT TAKE AS SECOND LANGUAGE?  KANNADA  HINDI  FRENCH

7. AWARDS WON SO FAR IN SPORTS, ARTS OR ACADEMICS ...............................................................................................................................................................................................……........

_______________________________________________________________________________________
C. ENCLOSURES (without which this application will not be accepted)

The following documents (recently attested photocopies) must be produced along with the filled application:

A) Birth Certificate

B) A copy of the latest progress report certified by the school in which the student last studied (if applicable)

C) Tahsildar’s Certificate: for Scheduled Castes, Scheduled Tribes or Backward Communities

D) TC (while paying 1st Term Fees)

PLEASE NOTE: Staple all documents to the top left-hand corner of the application
_______________________________________________________________________________________

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D. MISCELLANEOUS

How did you come to know about this school?

1) Name of the Newspaper / Edition :

2) Website :

3) Name of the Magazine :

4) Others (please specify) :

ANY SPECIAL INFORMATION THE APPLICANT MAY WISH TO MENTION ...........................................................................................................................................…………………………………….

.............................................................................................................................................................................................................................................................................................................………..

ARE YOU A RESIDENT IN ANY BRIGADE GROUP PROJECT? IF SO, SPECIFY ……………....................................................................................................................................................................

.............................................................................................................................................................................................................................................................................................................………..

REASONS FOR SEEKING ADMISSION TO THE BRIGADE SCHOOL @ GATEWAY ………………………………................................................................................................................…......………

.............................................................................................................................................................................................................................................................................................................………..

DECLARATION

I, ____________________________________________________________ represent that I have the authority to admit my child / ward

_____________________________________________________________, into the school as the parent / legal guardian.
I undertake to bring any fact, which may make this representation untrue in the future to the immediate notice of the school.
I declare that the statements given in this application are correct and, if found otherwise, I shall abide by the decision of the
management. I agree to abide by the rules and regulations and fee schedule of the school.

DATE: SIGNATURE OF PARENT / GUARDIAN

FOR THE USE OF THE SCHOOL OFFICE ONLY

PRINCIPAL CHAIRPERSON

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