Profession/ Designation
T: 7815 066 066E: [email protected]
No. 3643, 3rd Main, 2nd cross NS Palya Main RoadBTM Layout, 2nd StageBangalore 560076
1. Name of the student (As should be maintained in all school records)
(Please attach full details if any)
Mobile No. Mobile No.
Caste
Sibling (school & grade studying in)
Affix a recentpassport sizephotograph
11. Allergies (if any) :
13. Identification Mark:
12. Blood Group:
14. Father’s full name/ Guardian’s name (As per proof attached) (This will be maintained in all school records)
15. Mother’s full name/ Guardian’s name (As per proof attached) (This will be maintained in all school records)
20. In case of guardian, relationship with the student
21. Residential Address
BTM LAYOUTSCHOOLEKYA
Grade for whichadmission is
sought in words
Middle name (IN BLOCK LETTERS)
d d m m y y y y
Profession/ Designation
17. Phone No. (Office)16. Phone No. (Office)
18. E-mail 19. E-mail
Surname (IN BLOCK LETTERS)
First name (IN BLOCK LETTERS)
d d m m y y y y
Grades/ marks obtained in last exam
22. School last attended
23. Reasons for withdrawal
24. Details of previous schooling
25. Languages formally studied - First Second Third
26. Sports, games and activities involved in
29. Whether school conveyance is required
27. Recent accomplishments
Board of school last attended
1. Two passport size photographs2. Copy of the birth certificate3. School records covering the past 2 years4. Father’s/ Guardian’s ID proof5. Mother’s ID proof6. Caste certificate attested by Tahasildar7. Other relevant documents
28. Choice of 2nd Language (for Grades I to X): ______________________________________________
Choice of 3rd Language (for Grades V to VIII): _____________________________________________
Choice of Subjects (for Grade XI): _______________________________________________________
* Please note that registration for admission does not ensure admission.* Admission is granted based on merit against available vacancy only.* Admissions are subject to the discretion of Ekya Board of Governors.
I certify that the information I have provided in this application form is correct to the best of my knowledge.
CHOICE OF SUBJECTS