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Registration I
Form For

Registration BGSPS2023240048
BGS PUBLIC SCHOOL Number

Application form for registration into academic year 2023-24 Registration 07-10-2022 08:46
Date

Student Details

Student Name SKANDA SAMARTH HANDUR

Date of birth 23/07/2017

Age of the child as on 01 June 2021: 5 years, 10 months, and 9 days

Gender Male

Caste HINDU VEERASHAIVA LINGAYAT

Do you belong to SC / ST / OBC? No

Sub Caste

Aadhaar No 739267890992

Mother Tongue KANNADA

Nationality INDIAN

Religion HINDU

Languages

Details of Brothers / Sisters

# Name Brother/Sister Age Class Name Of the School

No Details of Brothers / Sisters

Parent Details

Father Mother

Name SAMARTH HANDUR RANJITA HANDUR

Mobile Number 9164579822 8553731500

Email Id samismaestroe@gmail.com ranjita.handur2016@gmail.com

Aadhaar No

Qualification B.E, MBA BA

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Profession/Designation ENGINEERING MANAGER HOMEMAKER

Department/Company name RAKUTEN INDIA ENTERPRISE PVT LTD, BAGMANE PALLAVI


with address TOWERS, SR NAGAR, BENGALURU

Department/Company phone
number

Annual Income(in INR) 3500000

Residential Address Details

Residence Address 001, LAKVIN LEITE, CONCORDE LAYOUT, 2ND KEMPEGOWDA MAIN ROAD,
RAJARAJESHWARI NAGAR, BENGALURU-560098
BENGALURU
KARNATAKA
India-560098

Phone Number

Distance from the School in KM 2

Payment Details

Registration Fee(INR) 1,000.00 20221007111212800110168711390520405


07-10-2022 08:46
Paid

Father Signature Mother Signature Date:

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