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An innovative Fine Art & Craft School for your kids

#34 (1st Floor), Shiva Nagar Path, Near Shanti Nivash, Ghoramara Chariali, Guwahati– 28
CONTACT NO. 87238 89363, 84040 52023 | WEBSITE: www.origamicreations.in

- APPLICATION FORM -
 Pay application fee (Rs. 100/-) at the authorised marketing centres only against the money
receipt duly signed by the representative.
 On showing of the money receipt, the application fee (Rs. 100/-) will be deduct from the
admission fee (Rs. 600/-) at the time of admission.
 Apart from the school premises or authorised marketing centres, do not pay any amount
to any individual or institution.

REFERRAL CODE If got any

FORM COLLECTED FROM Write if collected from any other person or our authorised marketing centres

STUDENT'S INFORMATION

NAME OF THE STUDENT: __________________________________________________________

DATE OF BIRTH: ____________________ GENDER: Male / Female / Others CASTE: ____________

NAME OF THE SCHOOL (Formal Education): ___________________________________________

__________________________________________________ CLASS: _______________________

PARENT'S DETAILS

Mother’s Name: _________________________________________________________________

Mobile Number: ________________________ Whatsapp Number: ________________________

Email id: ________________________________________________________________________

Father's Name: __________________________________________________________________

Mobile Number: ________________________ Whatsapp Number: ________________________

Email id: ________________________________________________________________________


PRESENT ADDRESS

House/Flat No: __________ Housing/Apartment Name: _________________________________

Byelane/Street Name: ____________________________________________________________

Landmark/Locality: _______________________________ Town/City: ______________________

District: ___________________________________ Pin code: _____________________________

PERMANENT ADDRESS

House/Flat No: __________ Housing/Apartment Name: _________________________________

Byelane/Street Name: ____________________________________________________________

Landmark/Locality: _______________________________ Town/Vill.: ______________________

District: ___________________________________ Pin code: _____________________________

DETAILS OF THE LAST FINE ART EXAMINATION PASSED

Name of Examination/Class: ________________________________________________________

Organisation/Art School: __________________________________________________________

Under the Board/Parishad/Society: __________________________________________________

________________ Year: _____________________ Result (in division): ____________________

C.S.No. (if appeared from Bangiya Sangeet Parishad): ___________________________________

AVERAGE MONTHLY FAMILY INCOME IS LESS THAN RS. 15,000/ – YES / NO

Form Provider’s Signature (in full) Guardian’s Signature (in full) Form Receiver’s Signature

Mob.No. ___________________ Date: __________________ Date: ________________