KERALA KALAMANDALA

Deemed University for Art and Culture
APPLICATION FORM

1

Surname of Family name

(Exactly as in Passport/Official identity Record)

:

2.

First name and Middle name
(Exactly as in Passport/Official identity Record)

:

3.

Other name
(Maiden, Religious, Professional, Aliases)

:

4.

Date of Birth (Day, Month, Year)

:

Date:

5.

Place of Birth

:

Town/City:

State/Province:

Country:

6.

Nationality

:

7.

Gender

Male

Female

8.

Place and Date (DD,MM,YY) of issue of Passport

:

Place:

Date:

9.

Date (DD,MM,YY) of Expiration of Passport

:

Date:

10.

Place and Date (DD, MM,YY) of issue of Indian Visa

:

Place:

Date:

11.

Type and Date (DD,MM,YY) of Expiration of Visa

:

Type:

Date:

12.

Home address

:

Apartment/House number:

Street:

City/Town:

State/Province:

Postal Code:

Telephone:

Fax:

Email address:

13.

Business address (if any) in full

:

14.

Color of hair

:

15.

Color of eyes

:

16.

Complexion

:

17.

Height

:

18.

Marks of identification

:

19.

Marital status (Check one)

:

Married:

Single:

Widowed:

Divorced:

Separated:

If married, give name and nationality of spouse

:

Name:

Nationality:

20.

Contact information of individual(s) to contact in an emergency

:

Phone No:

21.

What do you intend to study at Kalamandalam? Choose by checking one from the following

:

Kathakali

:

Acting:

Orchestra

:

Chenda:

Maddalam:

Koodiyattam

:

Acting Male/Felmale Character

orchestra (Mizhaavu)

Thullal

:

Panchavadyam (Kerala Ensemble) – Instrumental – Thimila

:

Classical Dance Mohiniyattam/Bharatanaatyam/ Kuchupudi

:

Make-up and Costuming

:

Classical Music: Vocal/Instrumental: Mridangam

:

Functional language: Malayalam/Sanskrit for students of performing arts

:

22.

Prior experience and training in respective art forms, if any?( Do write in brief and you may attach the

Copy Certificates.)

:

23.

What is the preferred date of commencing your study in Kalamandalam?

(Flexibility in this respect will enhance your chances for admission)

:

24.

How long do you plan to study in Kalamandalam?

(Course of study vary in duration from a few weeks to two years – intensity and credits)

:

Date:

To:

25.

Who will finance your study, including cost of travel and living?

26.

What type of accommodation your will like to have during your study in Kalmandalam?

Choose by checking one of the following

:

In the Foreign Students Hostel, with cooking facilities:

In the Foreign Students Hostel, with cooking facilities:

In a near by private residence, as a paying guest

27.

Details of payment and processing fee:

Account paid in check or draft of US $ 10/Rs.500

(payable to the Registrar, Kerala Kalamandalam, Cheruthuruthy, India):

Check Number

Name of bank which issues check:

:

28.

Dated signature: