THE BRIGADE SCHOOL
@ J P Nagar
Brigade Millennium Campus, J.P Nagar 7th Phase,
Bengaluru 560 078
Tel: 4130 1390 / 9880405427
[email protected] Website: BrigadeSchools.org
CBSE Affiliation No. 830111
Inward: ..........................................
EOI No: ..........................................
EOI Date ........................................
Expression of Interest Form 2017-18
Admission required for:
NURSERY
LKG
UKG
STD 1
STD 4
STD 5
STD 6
STD 7
1
STD 2
STD 3
Recent
passport-size
photograph of the
student to be
pasted here.
2
If admission is sought for Std 11, please select the combination from below:
SCIENCE STREAM
English (Core)
Physics
Chemistry
Mathematics / Psychology
Computer Science / Biology
COMMERCE STREAM
English (Core)
Accountancy
Business Studies
Economics
Mathematics / Psychology
ARTS STREAM
English (Core)
History
Psychology
Economics
Computer Science
PLEASE USE CAPITAL LETTERS ONLY. WHEREVER BOXES ARE PROVIDED, MARK YOUR CHOICE WITH A “”
APPLICATIONS WILL NOT BE ACCEPTED
INCOMPLETE
A. BACKGROUND DETAILS
FULL NAME OF THE STUDENT ....................................................................................................................................
(As it should appear in official school certificates)
DATE OF BIRTH
(No alteration will be allowed) DATE MONTH
FEMALE
YEAR
NATIONALITY ........................................................ RELIGION ................................................ MOTHER TONGUE .....................................
NO
S.C.
S.T.
Minority
NAME OF FATHER: ...................................................................................................... QUALIFICATIONS: ………………………………………….
DESIGNATION, ORGANISATION & OFFICE ADDRESS:..................................................................................................................................
……………………………………………………………………………………………………………………………………………………………………………………………………………
OFFICE PHONE ...................................................... MOBILE ............................................ E-MAIL ...........................................................
(Personal)
NAME OF MOTHER: ..................................................................................................... QUALIFICATIONS.................................................
DESIGNATION, ORGANISATION & OFFICE ADDRESS ..................................................................................................................................
……………………………………………………………………………………………………………………………………………………………………………………………………………
OFFICE PHONE ...................................................... MOBILE ............................................ E-MAIL ...........................................................
(Personal)
Mandatory to indicate email address and cell phone no. for all correspondence by underlining appropriately. School will
interact only with the parents of the child unless indicated otherwise.
PARENTS’ RESIDENTIAL ADDRESS ...........................................................................................................................................................
................................................................................................................................................................................................................
RESIDENCE PHONE ............................................ ANNUAL INCOME: FATHER Rs.: ................................ MOTHER Rs.: ...............................
PAGE 1/3
B. PERSONAL DATA
1. BLOOD GROUP: ……………………………………
2. DOES THE STUDENT HAVE A MAJOR AILMENT / ALLERGY THAT THE SCHOOL SHOULD KNOW ABOUT?....................................................
...............................................................................................................................................................................................................
3. ANY OTHER INFORMATION ..................................................................................................................................................................
...............................................................................................................................................................................................................
4. DETAILS OF BROTHERS/SISTERS OF THE STUDENT
NAME
AGE
INSTITUTION STUDYING IN
STANDARD
C. DETAILS OF PREVIOUS STUDY (If applicable)
1. NAME AND ADDRESS OF THE SCHOOL/PLAYSCHOOL IN WHICH THE STUDENT LAST STUDIED (for Nursery, play school can be mentioned)
............................................................................................................................................................................................................
............................................................................................................................................................................................................
2. STANDARD STUDYING IN AT PRESENT ................................................
3.
MEDIUM OF INSTRUCTION .....................................................
I C S E □ OTHER (Specify)
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 LANGUAGES WILL THE STUDENT TAKE? (Hindi is mandatory, as either second or third language option)
SECOND LANGUAGE
(STDS 1 - 5):
(STDS 6 -10):
(STDS 6 - 8):
THIRD LANGUAGE
□ KANNADA
□ KANNADA
□ KANNADA
□ HINDI
□ HINDI
□ HINDI
□ SANSKRIT
□ SANSKRIT
7. AWARDS WON SO FAR IN SPORTS/CO CURRICULAR/ACADEMICS/OTHER..............................................................................................
………………………………………………………………………………………………………………………………………….……………………………………………………………
D. ENCLOSURES (without which this form will not be recorded)
THE FOLLOWING DOCUMENTS (recently attested copies) MUST BE PRODUCED ALONG WITH THE COMPLETED FORM (stapled to top left hand corner):
1. BIRTH CERTIFICATE
2. LATEST PROGRESS REPORT CERTIFIED BY THE SCHOOL IN WHICH THE STUDENT LAST STUDIED / BONA FIDE CERTIFICATE FROM
PRINCIPAL OF THE SCHOOL WHERE THE CHILD IS STUDYING
3. TAHSILDAR’S CERTIFICATE FOR SCHEDULED CASTES, SCHEDULED TRIBES, BACKWARD COMMUNITY & MINORITY
E. MISCELLANEOUS
HOW DID YOU COME TO KNOW ABOUT THIS SCHOOL?
Website
Friends/Work Place
Other (Please specify) ........................................................................................................
ARE YOU A RESIDENT IN ANY BRIGADE GROUP PROJECT? IF SO, SPECIFY..................................................................................................
MENTION YOUR FIVE EXPECTATIONS FROM THE SCHOOL
1) ............................................................................................................................................................................................................
2) ............................................................................................................................................................................................................
3) ............................................................................................................................................................................................................
4) ............................................................................................................................................................................................................
5) ............................................................................................................................................................................................................
Please tick the appropriate box to indicate how you can support the school
1) Accompanying children on day trips
5) Story telling
2) Volunteering
6) Subject concept & introduction
3) Help with annual day
7) Others: ……………………………………………………………………
4) Substituting classes
………………………………………………………………………………………
PAGE 2/3
1.
FATHER’S NAME: ...............................................................................
FATHER’S SIGNATURE:........................................................................
DATE:
2.
.........................................................................
Recent
passport-size
photograph of the
father to be
pasted here.
MOTHER’S NAME : .............................................................................
MOTHER’S SIGNATURE: ……………………………………………………………………
DATE: ………………………………………………………………………………………………
Recent
passport-size
photograph of the
mother to be
pasted here
FOR THE USE OF SCHOOL ONLY
Checklist of documents required
1. Birth Certificate
2. Copy of latest progress report/Bona fide certificate from principal of the school where the child is studying
3. Tahsildar’s Certificate: for Scheduled Castes, Scheduled Tribes/Backward/Minority Communities
Follow up details:
Date:
Admin Executive
Remarks:
PRINCIPAL
CHAIRPERSON
Date:
Date:
PAGE 3 / 3