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1 Á sàªà À ÉÆ ÉÊn, PÀ â ï GzÁå ÀªÀ À, ÉAUÀ¼ÀÆgÀÄ BAL BHAVAN SOCIETY, CUBBON PARK, BANGALORE ÉùUÉ ² gàzà Cfð / APPICATION FOR SUMMER CAMP 2016 PÉÃAzÀæzÀ ºÉ ÀgÀÄ / NAME OF THE BAL BHAVAN 1 C sàåyðaiàä ºÉ ÀgÀÄ (zà Àà CPÀëgÀUÀ¼À è) NAME OF THE CANDIDATE (IN BLOCKLETTERS) 2 ºÉtÄÚ / UÀAqÀÄ MALE / FEMALE 3 d Àä ÁAPÀ ªÀÄvÀÄÛ ªÀAiÀÄ ÀÄì DATE OF BIRTH AND AGE 4 ªÀUÀð npï ªÀiÁr ( ) À.eÁ ( ) À. ÀA ( ) M ¹ ( ) ÁªÀiÁ Àå ( ) CATEGORY PLEASE ( ) SC ( ) ST ( ) OBC ( ) GENERAL ( ) 5 vàazé/vá Ä/ ÉÆõÀPÀgÀ ºÉ ÀgÀÄ ªÀÄvÀÄÛ «¼Á À NAME OF THE PARENT / GUARDIAN AND ADDRESS 6 ID 7 zàægàªátâ ÀASÉå TELEPHONE NUMBER 8 ªÁå ÀAUÀ ªÀiÁqÀÄwÛgÀĪÀ ±Á ÉAiÀÄ ºÉ ÀgÀÄ ( ÀPÁðj ±Á ÉAiÀÄ è N wûzàý è zár É MzÀV ÀĪÀÅzÀÄ)/ NAME OF THE SCHOOL 9 ÀæªÉñÀ AiÀÄ ÀĪÀ ZÀlĪÀnPÉ ACTIVITY TO WHICH ADMISSION SOUGHT 05 to 08 ( ) 08 to 12 ( ) 12 to 16 ( ) Res Mobile Office ½ ÀzÀ ÁåPÉÃeï/½ day Package { } ÀÆwð ÀzÀi ÁåPÉÃeï / Full day Package { } ÀævÉåÃPÀ ZÀlĪÀnPÉ/Individual activity { } ZÀlĪÀnPÉUÀ¼ÀÄ / Activities vàazé / vá Ä / ÉÆõÀPÀgÀ À» C sàåyðaiàä À» Signature of the parents / guardian Signature of the Candidate PÀbÉÃjAiÀÄ G ÀAiÉÆÃUÀPÁÌV ªÀiÁvÀæ / For office use only gàæ uà¼à ÀÄß gÀ¹Ã ÀASÉå ÁAPÀgÀ è ¹éÃPÀj À ÁVzÉ ÁAPÀ / Date ÀUÀzÀÄ ÀºÁAiÀÄPÀgÀ À»/ ÀUÀzÀÄ ¹éÃPÀj¹zÀªÀgÀÄ

2 Á sàªà À ÉÆ ÉÊn, PÀ â ï GzÁå ÀªÀ À É0UÀ¼ÀÆgÀÄ. zàægàªátâ \ É0UÀ¼ÀÆgÀÄ ÀUÀgÀzÀ ègàäªà PÉÃ0zÀæ Á sàªà À, PÀ â ï GzÁå ÀªÀ À, É0UÀ¼ÀÆgÀÄ, E èè Á0PÀ j0zà Á0PÀ gàªàgéué ÉùUÉ gàeé C0UÀªÁV 5-16 ªÀµÀðzÀ ªÀÄPÀ̽UÉ F PɼÀPÀ0qÀ «ªÀgÀzÀAvÉ ÀÈd ÁvÀäPÀ ºÁUÀÆ QæAiÀiÁvÀäPÀ ZÀlĪÀnPÉUÀ¼À è vàgà ÉÃw ÃqÀĪÀ UÉÎ Á sàªà ÀªÀÅ ÀæPÀn ÀÄvÀÛzÉ ªÀµÀðzÀ ªÀÄPÀ̽UÉ ÁåPÉÃeï ÉùUÉ ² gà - ² gàzà ÁªÀÄVæUÀ¼ÀÆ ÉÃjzÀ0vÉ M âjué gàæ.750\- ( AiÀiÁªÀÅzÁzÀgÀÆ 3 ZÀlĪÀnPÉ ªÀiÁvÀæ) PÀæ. ÀA. ªÉÃ¼É ZÀlĪÀnPÉ jazà PÀgÁmÉ CxÀªÁ AiÉÆÃUÀ jazà «gá ªÀÄ jazà avàæpà É / PÀgÀPÀıÀ É / eéãrªàätâú À PÀ É / ÀªÀÄƺÀ ÀÈvÀå / ÀªÀÄƺÀ VÃvÉ jazà avàæpà É / PÀgÀPÀıÀ É / eéãrªàätâú À PÀ É / ÀªÀÄƺÀ VÃvÉ ªÀµÀðzÀ ªÀÄPÀ̽UÉ ÁåPÉÃeï ÉùUÉ ² gà - ² gàzà ÁªÀÄVæUÀ¼ÀÆ ÉÃjzÀ0vÉ M âjué gàæ.1,000\- ( AiÀiÁªÀÅzÁzÀgÀÆ 5 ZÀlĪÀnPÉUÀ¼ÀÄ ªÀiÁvÀæ ) PÀæ. ÀA. ªÉÃ¼É ZÀlĪÀnPÉ jazà PÀgÁmÉ CxÀªÁ AiÉÆÃUÀ jazà «gá ªÀÄ jazà avàæpà É / PÀgÀPÀıÀ É / eéãrªàätâú À PÀ É / VmÁgï / và / Qà ÉÆÃqïð / ÀªÀÄƺÀ ÀÈvÀå / ÀªÀÄƺÀ VÃvÉ jazà ÀªÀÄƺÀ ÀÈvÀå / ÀªÀÄƺÀ VÃvÉ / avàæpà É / PÀgÀPÀıÀ É / eéãrªàätâú À PÀ É / VmÁgï / và / Qà ÉÆÃqïð jazà H l zà «gá ªÀÄ jazà dæåªé j ªÉÄÃQAUï ªÀÄvÀÄÛ ªÉĺÀA / PÀ À AzÀ gà À / AiÀÄPÀëUÁ À / PÁå UÁæ ü / JA Áæ ÄqÀj jazà dæåªé j ªÉÄÃQAUï ªÀÄvÀÄÛ ªÉĺÀA / PÀ À AzÀ gà À / AiÀÄPÀëUÁ À / PÁå UÁæ ü / JA Áæ ÄqÀj jazà gà A UÀ và gà Éà w

3 12-16 ªÀµÀðzÀ ªÀÄPÀ̽UÉ ÀævÉåÃPÀ ÉùUÉ ² gà - ² gàzà ÁªÀÄVæUÀ¼ÀÆ ÉÃjzÀ0vÉ M âjué ( ZÀlĪÀnPÉAiÉÆAzÀPÉÌ gàæ.750\- ªÀiÁvÀæ ) «±ÉõÀ DPÀµÀðuÉ PɼÀPÀAqÀ AiÀiÁªÀÅzÁzÀgÀÆ MAzÀÄ ZÀlĪÀnPÉUÉ ÁªÀw¹zÀÝ èè PÀgÁmÉ CxÀªÁ AiÉÆÃUÀ ZÀlĪÀnPÉ GavÀ ÀæªÉñÀ ( É TO 10.30) PÀæ. ÀA. ªÉÃ¼É ZÀlĪÀnPÉ jazà C Æå«Ä AiÀÄA sá Ä ï ªÀPïð ªÀÄvÀÄÛ ªÉÄl ï JA ÉÆùAUï CxÀªÁ ªÀÅqï ªÀPïð ªÀÄvÀÄÛ lærµà À ï Dmïð jazà C Æå«Ä AiÀÄA sá Ä ï ªÀPïð ªÀÄvÀÄÛ ªÉÄl ï JA ÉÆùAUï CxÀªÁ ªÀÅqï ªÀPïð ªÀÄvÀÄÛ lærµà À ï Dmïð jazà H l zà «gá ªÀÄ jazà KgÉÆêÀiÁqÉ AUï jazà séæãméæãuáæ ü I Batch TO II Batch TO CfðUÀ¼ÀÄ UÀ và Cfð ságà0uà¼à ÀÄß ªÉÆzÀ Ä 0zÀªÀjUÉ ªÉÆzÀ DzÀåvÉ ªÉÄÃgÉUÉ Á sàªà À, PÀ â ï GzÁå ÀªÀ À, É0UÀ¼ÀÆgÀÄ-1, E è ɽUÉÎ j0zà À0eÉ gàªàgéué Á0PÀ j0zà Á0PÀ gàªàgéué ÀqÉAiÀÄ ºÀÄzÀÄ. ( Á sàªà ÀzÀ gàeá ÀUÀ¼À ÀÄß ºÉÆgÀvÀÄ Àr¹) 2. jaiàiá Äw ÀPÁðj ±Á ÉUÀ¼À è NzÀÄwÛgÀĪÀ ªÀÄPÀ̼ÀÄ CªÀ±Àå zár É MzÀV¹ UÀ và ±ÀÄ ÌzÀ è ±ÉÃPÀqÀ 50% gàµàäö ±ÀÄ Ì jaiàiá Äw ÀqÉAiÀÄ ºÀÄzÀÄ. 3. GavÀ ÀæªÉñÀ ªÀµÀðzÉƼÀV À «PÀ ZÉÃvÀ À ªÀÄPÀ̼ÀÄ CªÀ±Àå zár É Ãr GavÀ ÀæªÉñÀ ÀqÉAiÀÄ ºÀÄzÁVzÉ.(±ÉÃPÀqÀ 3% gàµàäö ÀæªÉñÁªÀPÁ±À PÁ ÄÝj¹zÉ) 4. Á sàªà ÀzÀ ÀzÀ ÀåvÀé ÀqÉ gàäªà ªÀÄPÀ̽UÉ ±ÉÃPÀqÀ 25% gàµàäö ±ÀÄ Ì jaiàiá Äw ÃqÀ ÁUÀĪÀÅzÀÄ. ( ÀzÀ ÀåvÀé ÀqÉzÀÄ PÀ µà 6 wauà¼àä DVgÀ ÉÃPÀÄ ) 5. ² gàzà CªÀ üüaiàä è vàgà ÉÃw ÃrzÀ DAiÀÄÝ PÀ Á ªÀ ÀÄÛUÀ¼À ÀÄß»0wgÀÄV À ÁUÀĪÀÅ è. ² gàzà ÀªÀiÁgÉÆà À ÀªÀiÁgÀA sàªà ÀÄß gàazàä Á sàªà À, PÀ â ï GzÁå ÀªÀ À, É0UÀ¼ÀÆgÀÄ, E è K Àðr À ÁUÀĪÀÅzÀÄ. gàvàß PÀ ªÀÄzÁ PÁAiÀÄðzÀ²ðUÀ¼ÀÄ, Á sàªà À ÉÆ ÉÊn, ÉAUÀ¼ÀÆgÀÄ. qá. CAd A Á¼ÀÌgï CzsÀåPÀëgÀÄ, Á sàªà À ÉÆ ÉÊn, ÉAUÀ¼ÀÆgÀÄ.

4 BAL BHAVAN, CUBBON PARK, BANGALORE PHONE \ Bal Bhavan announces Summer Camp from to in Creative and Performing activities for the children in the age group of years at Central Bal Bhavan, Cubbon Park, Bangalore years PACKAGE SUMMER CAMP Rs. 750\- PER HEAD ( INCLUSIVE OF COURSE MATERIALS ) SELECT ANY 3 ACTIVITIES SL.No. Time Activity TO KARATE OR YOGA TO B R E A K TO PAINTING / CRAFT / CLAYMODELLING / GROUP DANCE / GROUP MUSIC TO PAINTING / CRAFT / CLAYMODELLING/ GROUP MUSIC 08-14years PACKAGE SUMMER CAMP Rs.1,000\- PER HEAD ( INCLUSIVE OF COURSE MATERIALS ) SELECT ANY 5 ACTIVITIES SL.No. Time Activity TO KARATE OR YOGA TO B R E A K TO PAINTING / CRAFT / CLAY MODELLING / GROUP DANCE / GROUP MUSIC/KEYBOARD/TABLA/GUITAR/ TO PAINTING / CRAFT / CLAY MODELLING / GROUP DANCE / GROUP MUSIC/KEYBOARD/TABLA/GUITAR/ TO L U N C H B R E A K TO JEWELLERY MAKING & MEHANDHI / WEALTH FROM TO WASTE / YAKSHAGANA/CALLIGRAPHY/EMBROIDERY JEWELLERY MAKING & MEHANDHI / WEALTH FROM TO WASTE / YAKSHAGANA/CALLIGRAPHY/EMBROIDERY THEATRE WORKSHOP

5 SUMMER CAMP FOR 12-16years Rs.750\- PER HEAD / PER ACTIVITITY ( INCLUSIVE OF COURSE MATERIALS ) SPECIAL ATTRACTION Entry free for Karate Or Yoga bet am TO 10.30am ( for children admitted any of the following activities ) SL.NO. Time Activity TO Aluminium Foil Works & Metal Embossing OR Wood Work & Traditional Art TO Aluminium Foil Works & Metal Embossing OR Wood Work & Traditional Art TO L U N C H B R E A K TO Aero Modelling TO Photography I Batch TO II Batch TO APPLICATIONS Applications will be issued from dt to dt between am to pm on all working days at Central Bal Bhavan, Cubbon Park, Bangalore. ( only on Bal Bhavan - working days) 2. Concession 50%Concession will be given for children studying in Government Schools. On production of necessary documents. 3. ADMISSION FREE 3% of Admissions free On First Come First Served Basis for special children between 05 & 16 years. On production of necessary documents % discount will be given for Member children ( eligibility only after 06 months of the membership ) 5. Art work will be retained done by the children during the course. Valedictory will on dt at Central Bal Bhavan. RATHNA B KALAMADANI Secretary, Bal Bhavan Society, Bangalore. Dr. ANJALI NIMBALKAR Chairperson, Bal Bhavan Society, Bangalore.

6 Á sàªà À ÉÆ ÉÊn, PÀ â ï GzÁå ÀªÀ À É0UÀ¼ÀÆgÀÄ. zàægàªátâ \ É0UÀ¼ÀÆgÀÄ ÀUÀgÀzÀ ègàäªà PɼÀPÀAqÀ «Ä Á sàªà ÀUÀ¼À è, Á0PÀ j0zà Á0PÀ gàªàgéué ÉùUÉ gàeé C0UÀªÁV 5-16 ªÀµÀðzÀ ªÀÄPÀ̽UÉ F PɼÀPÀ0qÀ «ªÀgÀzÀAvÉ ÀÈd ÁvÀäPÀ ºÁUÀÆ QæAiÀiÁvÀäPÀ ZÀlĪÀnPÉUÀ¼À è vàgà ÉÃw ÃqÀĪÀ UÉÎ Á sàªà ÀªÀÅ ÀæPÀn ÀÄvÀÛzÉ. 1. gáeáf ÀUÀgÀ «Ä Á sàªà À, UÁ ÄwæzÉëÁPïð, ªÀÄjAiÀÄ Àà À Á¼Àå, ÉAUÀ¼ÀÆgÀÄ PÉÆà ïì ÁPïð «Ä Á sàªà À, PÉÆà ïì ÁPïð, ÉAUÀ¼ÀÆgÀÄ. 3. daiàä ÀUÀgÀ «Ä Á sàªà À, 7 Éà ÁèPï, à ÀPï D ÀàvÉæ JzÀÄgÀÄ, PÉ.Dgï.gÀ ÉÛ, ÉAUÀ¼ÀÆgÀÄ. 4. fãªà À üãªàiá ÀUÀgÀ «Ä Á sàªà À, fãªà ï üãªàiá ÀUÀgÀ PÀqÉà ï ÁÝtzÀ ºÀwÛgÀ, ÉAUÀ¼ÀÆgÀÄ ªÀµÀðzÀ ªÀÄPÀ̽UÉ ÁåPÉÃeï ÉùUÉ ² gà - ² gàzà ÁªÀÄVæUÀ¼ÀÆ ÉÃjzÀ0vÉ M âjué gàæ.750\- ( AiÀiÁªÀÅzÁzÀgÀÆ 3 ZÀlĪÀnPÉ ªÀiÁvÀæ) PÀæ. ÀA. ªÉÃ¼É ZÀlĪÀnPÉ jazà AiÉÆÃUÀ jazà «gá ªÀÄ jazà avàæpà É,PÀgÀPÀıÀ É ªÀÄvÀÄÛ eéãrªàätâú À PÀ É/ ÀªÀÄƺÀ ÀÈvÀå ªÀÄvÀÄÛ ÀªÀÄƺÀ VÃvÉ jazà avàæpà É,PÀgÀPÀıÀ É ªÀÄvÀÄÛ eéãrªàätâú À PÀ É/ ÀªÀÄƺÀ ÀÈvÀå ªÀÄvÀÄÛ ÀªÀÄƺÀ VÃvÉ 1. CfðUÀ¼ÀÄ UÀ và Cfð ságà0uà¼à ÀÄß ªÉÆzÀ Ä 0zÀªÀjUÉ ªÉÆzÀ DzÀåvÉ ªÉÄÃgÉUÉ Á sàªà À, PÀ â ï GzÁå ÀªÀ À, É0UÀ¼ÀÆgÀÄ-1, E è ɽUÉÎ j0zà À0eÉ gàªàgéué Á0PÀ j0zà Á0PÀ gàªàgéué ÀqÉAiÀÄ ºÀÄzÀÄ. ( Á sàªà ÀzÀ gàeá ÀUÀ¼À ÀÄß ºÉÆgÀvÀÄ Àr¹) 2. jaiàiá Äw ÀPÁðj ±Á ÉUÀ¼À è NzÀÄwÛgÀĪÀ ªÀÄPÀ̼ÀÄ CªÀ±Àå zár É MzÀV¹ UÀ và ±ÀÄ ÌzÀ è ±ÉÃPÀqÀ 50% gàµàäö ±ÀÄ Ì jaiàiá Äw ÀqÉAiÀÄ ºÀÄzÀÄ. 3. GavÀ ÀæªÉñÀ ªÀµÀðzÉƼÀV À «PÀ ZÉÃvÀ À ªÀÄPÀ̼ÀÄ CªÀ±Àå zár É Ãr GavÀ ÀæªÉñÀ ÀqÉAiÀÄ ºÀÄzÁVzÉ. ( ±ÉÃPÀqÀ 3 gàµàäö ÀæªÉñÁªÀPÁ±À PÁ ÄÝj À ÁVzÉ) 4. Á sàªà ÀzÀ ÀzÀ ÀåvÀé ÀqÉ gàäªà ªÀÄPÀ̽UÉ ±ÉÃPÀqÀ 25% gàµàäö ±ÀÄ Ì jaiàiá Äw ÃqÀ ÁUÀĪÀÅzÀÄ. ( ÀzÀ ÀåvÀé ÀqÉzÀÄ PÀ µà 6 wauà¼àä DVgÀ ÉÃPÀÄ ) 5. ² gàzà CªÀ üüaiàä è vàgà ÉÃw ÃrzÀ DAiÀÄÝ PÀ Á ªÀ ÀÄÛUÀ¼À ÀÄß»0wgÀÄV À ÁUÀĪÀÅ è. ² gàzà ÀªÀiÁgÉÆà À ÀªÀiÁgÀA sàªà ÀÄß gàazàä Á sàªà À, PÀ â ï GzÁå ÀªÀ À, É0UÀ¼ÀÆgÀÄ, E è K Àðr À ÁUÀĪÀÅzÀÄ. gàvàß PÀ ªÀÄzÁ PÁAiÀÄðzÀ²ðUÀ¼ÀÄ, Á sàªà À ÉÆ ÉÊn, ÉAUÀ¼ÀÆgÀÄ. qá. CAd A Á¼ÀÌgï CzsÀåPÀëgÀÄ, Á sàªà À ÉÆ ÉÊn, ÉAUÀ¼ÀÆgÀÄ

7 BAL BHAVAN, CUBBON PARK, BANGALORE PHONE \ Bal Bhavan announces Summer Camp from to in Creative and Performing activities for the children in the age group of years at the following Mini Bal Bhavans- 1. Rajajinagar Mini Bal Bhavan, Gayathri Devi Park, Mariyappanapalya, Bangalore Coles Park, Mini Bal Bhavan, Coles Park, Bangalore. 3. Jayanagar Mini Bal Bhvan, 7 th Block, opp., Deepak Hospital, k.r. Road, Bangalore. 4. Jeevan Bheema Nagar Mini Bal Bhavan, Near Jeevan Bheema Nagar Bus Terminals, Bangalore. SL. No years PACKAGE SUMMER CAMP Rs. 750\- PER HEAD Time ( INCLUSIVE OF COURSE MATERIALS ) SELECT ANY 3 ACTIVITIES Activity TO YOGA TO B R E A K TO PAINTING,CRAFT & CLAYMODELLING / GROUP DANCE & MUSIC TO PAINTING,CRAFT & CLAYMODELLING / GROUP DANCE & MUSIC 1. APPLICATIONS Applications will be issued from dt to dt between am to pm on all working days at Central Bal Bhavan, Cubbon Park, Bangalore. ( only on working days) 6. Concession 50% concessions will be given for children studying in Government Schools. On production of necessary documents. 7. ADMISSION FREE 3% of Admissions free On First Come First Served Basis for special children between 05 & 16 years. On production of necessary documents % discount will be given for Member children ( eligibility only after 06 months of the membership ) 9. Art work will be retained done by the children during the course. Valedictory will be on dt at Central Bal Bhavan, Cubbon Park, Bangalore. RATHNA B KALAMADANI Secretary, Bal Bhavan Society, Bangalore. Dr. ANJALI NIMBALKAR Chairperson, Bal Bhavan Society, Bangalore.

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