BMTC Bus Pass Form
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BANGALORE METROPOLITAN TRANSPORT CORPORATION (Students Concessional Bus Pass Application) To be filled in Block letters Full Name: ……………………………………………………………… DoB:……………………….…………Age:…………………… Gender: ……………………………… Present Postal address:……………………………………………………….…… Door #:………………………… Street:…………….. Locality:……………………….pin code:……………. Name of the Parent/guardian: ……………. Permanent address………………... Contact ………………………………. Tel.No: ……………….. ………………………………. Email Address: ………………… ………………………………. Student’s Requirement : Ordinary pass / Travel as you like pass / Renewal / Extension Travel Details Class:…………………….. Educational Institution:………………… From:……………………… To:……………………… Place of Changeover:……………………………………….....Distance (in KM)……………….. Validity Period: ……………. …. to………………… Signature of Parent/Guardian Student’s Signature -------------------------------------------------------------------------------------------------------------------------- Certificate from Educational Institution The above information furnished by the student studying in our Educational Institution is true as per our knowledge. Student’s Registration No: Signature of Head of the Institution with seal & Date -------------------------------------------------------------------------------------------------------------------------- Terms& Conditions Production of the following document is compulsory : 1) Original fee Receipt for the current academic year. 2) Identity Card issued by the Educational Institution. 3) 2 Photo Rules to be followed Pass not transferable – to be produced for inspection on demand by BMTC authorities - Rs.100/-+ fee for the balance validity period to be paid for obtaining Duplicate Pass after due Police formalities in case of loss during the validity period. Affix a recent stamp size Photo of the applicant with seal & sign of institution
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BMTC Bus Pass Form
Transcript of BMTC Bus Pass Form
BANGALORE METROPOLITAN TRANSPORT CORPORATION
(Students Concessional Bus Pass Application)
To be filled in Block letters
Full Name: ………………………………………………………………
DoB:……………………….…………Age:……………………
Gender: ………………………………
Present Postal address:……………………………………………………….……
Door #:………………………… Street:……………..
Locality:……………………….pin code:…………….
Name of the Parent/guardian: …………….
Permanent address………………... Contact
………………………………. Tel.No: ………………..
………………………………. Email Address: …………………
……………………………….
Student’s Requirement : Ordinary pass / Travel as you like pass / Renewal / Extension
Travel Details
Class:…………………….. Educational Institution:…………………
From:……………………… To:………………………
Place of Changeover:……………………………………….....Distance (in KM)………………..
Validity Period: ……………. …. to…………………
Signature of Parent/Guardian Student’s Signature
--------------------------------------------------------------------------------------------------------------------------
Certificate from Educational Institution
The above information furnished by the student studying in our Educational Institution is true
as per our knowledge.
Student’s Registration No: Signature of Head of the
Institution with seal & Date
--------------------------------------------------------------------------------------------------------------------------
Terms& Conditions
Production of the following document is compulsory :
1) Original fee Receipt for the current academic year.
2) Identity Card issued by the Educational Institution. 3) 2 Photo
Rules to be followed
Pass not transferable – to be produced for inspection on demand by BMTC authorities -
Rs.100/-+ fee for the balance validity period to be paid for obtaining Duplicate Pass after due Police
formalities in case of loss during the validity period.
Affix a recent
stamp size
Photo of the
applicant with
seal & sign of
institution
