K A LA Roll No. ………………………......

Photograph duly self

ACHEEN
attested and to be

KENDRA
PRACHEEN KALA KENDRA affixed in case of
PR

candidates appearing in
Bhushan Part-1
Estd 1956
SECTOR 35-B, CHANDIGARH – 160 022 (1st year) and onward
Email : pracheenkalakendra@gmail.com examinations.

Examination Form for Annual/Bi-Annual/Bhaskar Examination Session 20___20___

1. Name of the Candidate (in Block letters)

2. Father's Name (in Block letters) - MANDATORY

3. Mother's Name (in Block letters)

4. Full Address with Phone Number __________________________________________________________

__________________________________________________________
5. Date of Birth and Sex _________________________ Sex Male Female Others (Please Tick)
6. Nationality and Mother Tongue __________________________________________________________
7. Class and Subject in which the Class _____________________________________________________
candidate is appearing Subject ___________________________________________________
8. (a) Details of previous examination _________________________________________________________
if any, passed by the candidate in Roll No. _________________________ Class ____________________
Music, Dance, Fine Arts (Painting) Subject _________________________ Session___________________
Result ____________________________________________________
(b) Name of the centre / ______________________________________________________________
address and affiliated to ______________________________________________________________
which organization ______________________________________________________________
9. Educational Qualification ______________________________________________________________
(Matric pass certificate to be attached for 4th and 5th year and Higher Secondary/ Senior Secondary Certificate for Bhaskar Examination).
10. Name of the Affiliated Examination Centre from which the candidate wants to appear_______________
________________________________________________________________________________________
SOLEMN DECLARATION: I solemnly declare that the particulars given above in the form are true and correct. I accept full
liability for any action against me under the rules and regulations of the Kendra for any mis-statement or concealment of facts made
by me. I further pledge to abide by the rules/instructions laid down by the Kendra. I have carefully and completely read/informed
about the important instructions overleaf and will comply with the same. I further declare that I am fully aware of recognition of
certificates / diplomas awarded by PKK & is fully satisfied about the same.

Date:________________ Guardian's Signature Full Signature of the Candidate

Place:_______________ (In case of Minor candidate)
DECLARATION BY THE CENTRE INCHARGE: I declare that the candidate stated above bears a good moral character and
is eligible for the said examination. I have scrutinised the examination form and declare that the entries mentioned above are
correct. I have completely and carefully read the important instructions overleaf and this examination form is in compliance with
the same. I am also satisfied qua the recognition of the certificates of the diplomas awarded by the Pracheen Kala Kendra.

Email : ___________________________________ Signature of Centre Incharge with Centre Seal

Mobile No.________________________________ Centre Registration No. ____________________

ADMIT CARD PRACHEEN KALA KENDRA, CHANDIGARH Roll No. ___________________

To be filled in by the candidate (To be allotted by the Kendra)

Admit ___________________________ son/daughter of ____________________ Photograph duly self

Subject__________________________ Class ___________ Session __________ attested and to be
affixed in case of
Centre of Examination & Regn. No. _____________________________________ candidates appearing
in Bhushan Part-1
(1st year) and onward
examinations.
Signature of the Candidate REGISTRAR
 IMPORTANT INSTRUCTIONS
1. Incomplete form shall not be entertained.
2. All columns of the examination form shall be filled in neatly and correctly otherwise it is liable to
be rejected by the Kendra.
3. An attested copy of the certificate (Marks sheet) of the lower/previous examination passed in
music, dance or fine arts (painting) from the Kendra or any other recognized institution or
charterted university must be submitted by each candidate appearing in the examination of
Bhushan Part-2 (2nd year) and above alongwith the examination form, otherwise it is liable to
cancelled.
4. The minimum age to appear in any of the Kendra's examinations at the time of Theory
examination is as follows:
(a) Visharad Part-1 (4th year) – 15 years complete
(b) Visharad final- (5th year) – 16 years complete
(c) Bhaskar Part-1 (6th year) – 18 years complete
(d) Bhaskar final (7th year) – 19 years complete
5. Photostat copy of the Date of Birth certificate (as on Matriculation certificate) duly attested by the
Gazatted officer must be attached with the examination form for 4th year and onwards
examination, otherwise it is liable to be cancelled. Photocopy of Higher Secondary 12th pass
certificate is mandatory for appearing in the Bhaskar Examination.
6. In the absence or receipt of the required document(s) with the examination form within the
specified period, the result of the concerned candidate, even if he/she appeared in the
examination, shall be withheld/cancelled.
7. From Bhushan final (3rd year) onwards, the candidate is permitted to appear only in one subject
once in the academic year. In case a candidate appears in an examination in more than one
subject, his/her candidature shall be automatically cancelled and no correspondence shall be
entertained in this behalf. Even upto Bhushan final (3rd year) examination if the timings are
clashing, the candidate shall be permitted to appear in one subject only.
8. There will be no refund of Exam fee/form fee/certificate fee against cancelled candidate/s
9. Examination forms will not be accepted without certificate fee for each form.
10. As per the prevailing rules, 10% less will be given only on examination fees.
11. Please go through the above stated instructions carefully before filling the examination form
failing which it is liable to be rejected/cancelled
12. All disputes subject to Chandigarh Jurisdiction only

EXAMINATION FEE
(The money shall be remitted through Bank draft in favour of Pracheen Kala Kendra, Chandigarh.

Class Examination Centre fee Form Fee Certificate

fee fee
Prarambhik Part-1 135/- 100/- Rs. 15/- 15/-
Prarambhik Part-2 140/- 110/- Rs. 15/- 15/-
Bhushan Part-1 (1st Year) 165/- 125/- Rs. 15/- 15/-
Bhushan Part-2 (2nd Year) 180/- 135/- Rs. 15/- 15/-
Bhushan Final (3rd Year) 205/- 150/- Rs. 15/- 15/-
Visharad Part-1 (4th Year) 225/- 160/- Rs. 15/- 15/-
Visharad Final (5th Year) 300/- 185/- Rs. 15/- 130/-
Bhaskar Part-1 (6th Year) 570/- 270/- Rs. 15/- 150/-
Bhaskar Final (7th Year) 750/- 350/- Rs. 15/- 150/-