Form No: DIPLOMA IN EVENT MANAGEMENT info@fame.ac.in | www.fame.ac.in ______________________________________________________________________________________________________________________________________ Completed Application Form to be returned to: 108/B, 1st floor, Lalchand Complex, Master Canteen, Bhubaneswar, Odisha, Telephone : 0674-2531862, +91 9583147685 To be completed personally by the applicant using BLOCK LETTER, BLACK/BLUE Ball pen. Please attach the necessary supporting documents Father’s / Guardian’s Name: Date of Birth: Gender: Male Female Nationality: Marital Status: Affix Photograph Permanent Address: Present Address: Mobile No.: Landline No: Employed or Non-Employed: If Employed, please give the position held along with the Name & Address of the Organisation Languages Known: Language Known Read Speak Write Academic Qualification: Examination Passed Board / Univ. / College Year Subjects Division / Percentage High School Higher Secondary Graduation Professional / Technical Qualification: Qualication Details / Title Board / Univ. / College Division / Percentage Year APPLICATION FORM Name: DECLARATION: I also declare that on admission I shall submit myself to the rules and regulations and the disciplinary control of the management of First Academy of Media and Entertainment (FAME).I agree that in all matters the decision of the Management of FAME will be final. The Academy reserves the right to cancel the provisional admission in case I fail to submit the original documents for verification and pay the dues within the stipulated time. __________________________________ __________________________________ Signature of the Applicant Signature of Parents/Guardian Date: ___________________ DOCUMENTS REQUIRED TO BE ENCLOSED WITH APPLICATION FORM: Self attested True Copies Only: 10th, 12th and Graduation Mark sheet & Certificate Conduct certificate / College leaving certificate from the institution last attended Extra Curricular Achievements / Work Experience Certificate (if any) 4 recent color passport size photographs of the applicant ( Note: Original documents to be produced for verification at the time of Admission) Date: ___________________ APPLICATION FORM I _____________________________ son/daughter/wife of __________________________ hereby sincerely affirm that the statements made and information furnished by me in and with the application form are true, complete and correct.
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