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    Application Form 2017

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    Petro Paulo
    This document appears to be an application form for the Chitrakala puraskar 2017 art competition hosted by Artkerala Muzris. The form requests information such as the applicant's name, address, date of birth, art education background, details of the artwork being submitted including size, medium and title. The applicant must also declare that the information provided is true, the artwork is their original creation from the specified year and agree to the terms of the competition. A registration fee of Rs. 2000 for Indian applicants or Rs. 5000 for international applicants must be submitted via bank draft, postal order or bank transfer to Artkerala Muzris' specified bank account.

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    Application Form 2017

    Uploaded by

    Petro Paulo
    6 views1 page
    This document appears to be an application form for the Chitrakala puraskar 2017 art competition hosted by Artkerala Muzris. The form requests information such as the applicant's name, address, date of birth, art education background, details of the artwork being submitted including size, medium and title. The applicant must also declare that the information provided is true, the artwork is their original creation from the specified year and agree to the terms of the competition. A registration fee of Rs. 2000 for Indian applicants or Rs. 5000 for international applicants must be submitted via bank draft, postal order or bank transfer to Artkerala Muzris' specified bank account.

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    This document appears to be an application form for the Chitrakala puraskar 2017 art competition hosted by Artkerala Muzris. The form requests information such as the applicant's name, address, date of birth, art education background, details of the artwork being submitted including size, medium and title. The applicant must also declare that the information provided is true, the artwork is their original creation from the specified year and agree to the terms of the competition. A registration fee of Rs. 2000 for Indian applicants or Rs. 5000 for international applicants must be submitted via bank draft, postal order or bank transfer to Artkerala Muzris' specified bank account.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    6 views1 page

    Application Form 2017

    Uploaded by

    Petro Paulo
    This document appears to be an application form for the Chitrakala puraskar 2017 art competition hosted by Artkerala Muzris. The form requests information such as the applicant's name, address, date of birth, art education background, details of the artwork being submitted including size, medium and title. The applicant must also declare that the information provided is true, the artwork is their original creation from the specified year and agree to the terms of the competition. A registration fee of Rs. 2000 for Indian applicants or Rs. 5000 for international applicants must be submitted via bank draft, postal order or bank transfer to Artkerala Muzris' specified bank account.

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    ARTKERALA MUZRIS

    12/187, Santo Gopalan Road, Kochi - 682 002,


    Ernakulam Dist., Kerala. India.
    Email: artkeralamuzris@gmail.com, www.artkeralamuzris.com
    PHOTO

    Chithrakala puraskar 2017


    Name (as in Bank Account) : ..............................................................................................................

    Street Address : ..............................................................................................................

    : ..............................................................................................................

    State : ..............................................................................................................

    City : ..............................................................................................................

    Pin Code : ..............................................................................................................

    Country : ..............................................................................................................

    Date of Birth / Place : ..............................................................................................................

    Art Education : ..............................................................................................................

    : ..............................................................................................................

    Art Category : ..............................................................................................................

    Title of Artwork : ..............................................................................................................

    Size / Medium : ..............................................................................................................

    Rate of Ar work : ..............................................................................................................

    Description of Artwork : ..............................................................................................................

    I solemnly declare that

    1. I.......................................................... Age .................., ..................................... Resident, am an Artist.

    2.The information filled by me in the above form is correct. Photo pasted above is my image.

    3. I am enclosing CD containing my artwork, my photo image & Bio Data.

    4. I am sending herewith a Bank draft / postal order / bank transfer of Rs. 2000 (indian) & Aborad Rs. 5000.

    5. the artwork shown in enclosed CD is my own creation in the year ...................................................

    6.The content of 1, 2, and 5 above are true and correct.

    7. I agree to the terms and conditions of Chitrakala puraskar 2017 contest.

    I hereby affirm the above Declaration and verify the same.

    ...........................................

    Signature

    Draw the Bank Draft / Postal Order of Entry fee in the an name of “ Artkerala Muzris”.

    Account Name : Artkerala Muzris

    Bank Details : Bank of India, Branch : Kadavanthra, Ernakulam, Kerala.

    Account Number : 858720110000091, IFSC Code: BKID0008587

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