K C G I

Karnataka Education Trust®

KARNATAKA PUBLIC SCHOOL

Affiliated to CBSE New Delhi, Affilia�on No: 830223, School Code: 41059 PHOTO
# 22/1, Chokkanahalli, Hegde Nagar Main Road, Bangalore – 560 064.
E-mail: ketkps@gmail.com www: karnatakapublicschool.com

APPLICATION FORM
Note: Please read carefully before filling the application. Write in BLOCK letters within the space provided.

Do not leave any blank spaces.

CLASS IN TO WHICH ADMISSION REQUIRED: .................................................................................................

PERSONAL DETAILS

Name of the student ........................................................................................................................................

Date of Birth :................................... (DD/MM/YY) In words ...........................................................................

Age:....................Sex:............................ (M/F) Mother Tongue:........................................................................

Na�onality:................................................... Religion......................................................................................

Caste:............................................................. Sub Caste: .................................................................................

Blood Group:.................................................. Languages Known:.....................................................................

Aadhar No:........................................................................................................................................................

Email: ................................................................................................................................................................

Language op�ons: 1st ......................................... 2nd ......................................... 3rd ..........................................

Father’s Name & Qualifica�on..........................................................................................................................

Occupa�on.................................................................................. Annual Income:............................................

Father’s Aadhar No ..........................................................................................................................................

Telephone: ...............................................................WhatsApp No: ..................................................................

Email: .................................................................................................................................................................

Mother’s Name& Qualifica�on..........................................................................................................................

Occupa�on.................................................................................. Annual Income:.............................................

Mother’s Aadhar No .........................................................................................................................................

Telephone: ............................................ WhatsApp No: ...................................................................................

Email: ................................................................................................................................................................

Permanent Address: House no & Street...........................................................................................................

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

Village/Town/City...............................................................................................................................................

State:...........................................................................PIN:................................................................................

correspondence Address: House no & Street....................................................................................................

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

Village/Town/City...............................................................................................................................................

State:...........................................................................PIN:................................................................................

Name of the School last a�ended:.....................................................................................................................

Class in which the pupil last studied:.................................................................................................................

Medium of instruc�on:........................................................................................(English/Regional language)

SIBLING’S DETAILS:

Name:...............................................................................................................Class : ......................................

School/College Name:.......................................................................................................................................
INSTRUCTIONS:
1. Please enter the correct spelling of the Pupil’s, parents names and other informa�on as it is in the
previous school TC.
2. Admission is subject to the availability of seats.
3. Fee once paid shall not be refunded under any circumstances.
4. Transfer of the school in the middle of the academic year is not permi�ed without genuine reason.
5. On admission confirma�on, the following documents should be submi�ed within the s�pulated date
to the school.

• Birth Cer�ficate from the Municipal Corpora�on / Civic Authori�es

• A copy of the latest progress report cer�fied by the school in which the student last studied
(if applicable)

• 3 individual passport size colour photographs of the students and the parents.

• Transfer Cer�ficate / Migra�on Cer�ficate

• Caste Cer�ficate

• Income Cer�ficates

• A copy of Aadhar card of candidate, and parents.

PARENTS PHOTO (Mother & Father)

PHOTO PHOTO

DECLARATION
I hereby declare that the par�culars furnished herein are correct.
If my child is admi�ed in this School, I shall co-operate with the authori�es of the school in ma�ers
of discipline, sports & extracurricular ac�vi�es and in any other manner in which I may be called
upon to help.
I shall abide by the rules and regula�ons of the Ins�tu�on in force, which may be amended / altered
from �me to �me by the Management.

Signature of the Parent or Guardian

Date: Name:
 FOR OFFICE USE ONLY

1. Applica�on issued on.............................................................................................................................

Applica�on fee: Rs......................................................Receipt No.........................Dated:......................

2. Applica�on Submission Date:................................................................................................................

Admission fee: Rs........................................................Receipt No.........................Dated:......................

3. Books & Uniform Fee: Rs.............................................Receipt No........................Dated:......................

4. Tui�on fee: Rs.........................................................................................................................................

5. Any Other fee: Rs:..................................................................................................................................

Original Cer�ficates Submi�ed

1. Birth Cer�ficate Yes/No

2. Transfer Certificate Yes/No

3. Marks statement Yes/No

4. Caste Cer�ficate Yes/No

5. Income Cer�ficate Yes/No

6. Passport size Photographs Yes/No

7. Copies of Aadhar cards Yes/No

Any other remarks:-

Signature of the Admission in charge Accountant Signature of the Principal