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:
.
Students 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 Students Signature
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Certificate from Educational Institution
The above information furnished by the student studying in our Educational Institution is true
as per our knowledge.

Students Registration No: Signature of Head of the
Institution with seal & Date

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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