Institution Data Collection

Institution Data Collection Form

For Schools, Colleges, Classes, Nurseries & Educational Institutes

SECTION 1: Institution Details

1. Name of Institution (School / College / Class / Nursery) *

2. Type of Institution *

3. Affiliation / Board (if applicable)

4. Institution Address *

5. Landmark

6. City *

7. Pin Code *

8. Website (if available)

SECTION 2: Key Contact Persons

1. Name of Principal / Head of Institution *

2. Principal's Mobile Number *

3. Principal's Email ID

4. Name of Coordinator / Administrator

5. Coordinator's Mobile Number

6. Coordinator's Email ID

7. Name of Office Staff / Reception Contact (optional)

8. Office Contact Number

SECTION 3: Student & Staff Strength

1. Total Students in Pre-Primary / Nursery

2. Total Students in Primary (Std 1–4)

3. Total Students in Secondary (Std 5–10)

4. Total Junior College Students (11th–12th)

5. Total Degree College Students

6. Total Students in Coaching Classes (if applicable)

7. Total Number of Teachers

8. Total Number of Non-Teaching Staff

9. Total Number of Buses / Vans (if applicable)

SECTION 4: BMS Brochure Distribution Permission

1. Has the Principal granted permission to distribute BMS brochures to all students? *

2. Preferred Mode of Distribution *

3. Preferred Date & Time for Distribution

SECTION 5: Additional Information

1. Does the institution conduct health camps?

2. Would the institution be interested in collaborating with BMS for:

Free Health Awareness Session

Free Eye Check-up Camp

Free Diabetes & BP Camp

Free General Health Camp

Parent Awareness Seminar

Teacher Wellness Program

Other

3. Any special instructions or comments from the Principal / Coordinator

SECTION 6: BMS Sales Executive Details

1. Sales Executive Name *

2. Sales Executive Mobile Number *

3. Date of Visit *

Please review all information before submitting