Application Form Number

WBFA

AMRITA SCHOOL OF ARTS AND SCIENCES

BRAHMASTHANAM, EDAPPALLY NORTH P.O., KOCHI – 682 024, KERALA, INDIA.
PHONE: 0484 - 2802899, 2801489, 2801965. FAX: 0484 - 2802511
E-mail ID: asaskochi@gmail.com, admisssions.asaskochi@gmail.com

APPLICATION FORM FOR ADMISSION (2018) TO UNDER - GRADUATE PROGRAMME

BACHELOR OF FINE ARTS [B.F.A.]
4 Years (8 Semesters) (Offered for BOYS and GIRLS)
Specialisations (Put Tick Mark () whichever is applicable)

Specialising in Painting Specialising in Photography

[Please read the “INSTRUCTIONS TO CANDIDATES” and “FAQ“ before filling this Application Form. All entries to be
made in BLOCK LETTERS. Fill in all the details IN CANDIDATES OWN HANDWRITING. INCOMPLETE APPLICATION FORM
is liable for rejection. Enclose ONLY self – attested photocopies of Marklists.]

1. Name of the Applicant as given in the S.S.L.C. Book (leave blank space between first name and initials)

2. Date of birth : (Date)______(Month) ______ (Year)___________Completed Age:______

3. Gender:( Male / Female) Blood Group: _________
4. Place of Birth: ________________________________
Affix recent
District: _________________________ State: _______________________
Passport size
photograph
5. Religion:____________Caste:____________ Community (SC/ST/OBC/OEC/Gen/Others)_________

6. Mother Tongue:___________________ 7. Nationality:_______________

8 (a). Address for Communication: __________________________________________________________________

__________________________________________________________________

Post Office:__________________________________________________________________

District:_____________________State:_____________________ Pin Code: ___________

Phone No. (with STD Code):_______________________ E-mail:________________________________________

Father’s Mobile Number:_______________________ Mother’s Mobile Number:_________________________
Father’s E-mail ID: ___________________________ Mother’s E-mail ID: ______________________________
8 (b). Permanent Address: ________________________________________________________________________

_________________________________________________________________________
Post Office:_________________________________________________________________________
District:_______________________State:_______________________ Pin Code: _____________
Phone No. (with STD Code): ___________________________E-mail:_________________________________

Alternate contact Phone (Mobile and Landline with STD Code)

with the name of the person and relationship with the student: ______________________________________
9 (a). Father’s Name: ______________________________________________________________________________

Occupation (specify) _______________________________________ Annual Income ______________________

Office Address with Phone No. (if any) ___________________________________________________________

___________________________________________________________________________________________

9 (b). Mother’s Name: ______________________________________________________________________________

Occupation (specify) _______________________________________ Annual Income ______________________

Office Address with Phone No. (if any) ___________________________________________________________

___________________________________________________________________________________________

9 (c). Do you have Brothers or Sisters? If yes, give their names:________________________________________________

10. Name and address of Local Guardian (if any) __________________________________________________________

___________________________________________________________

Post Office:___________________________________________________________

District:___________________State:____________________ Pin Code: __________

Phone No. (with STD Code) _____________________________ Mobile No. _____________________________

E-Mail ID____________________________________________Relationship with student: _____________________

11. Name of the School / Institution last studied for the qualifying examination:

a) Name of the School / Institution: _____________________________________________________________

b) Address with Pincode: _____________________________________________________________________

c) Group: __________________________________________________________________________________

d) Month and Year of passing: _________________________________________________________________

e) Board / University: ________________________________________________________________________

f) Subjects studied:__________________________________________________________________________

12. What is the present stage of your study: Course completed / Appeared in final examination / Result awaited / Qualified

(strike out whichever is not applicable)

13. Marks obtained in the qualifying examination:

(Enclose self - attested photocopies of 10th and 12th mark sheets)

Class Marks Obtained Maximum Marks % of Marks No. of Attempts
10th
12th

14. Major Extra Curricular Activities

Year Honours
No. Activity Remarks
From To Received (if any)

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15. Reason for choosing the AMRITA school for your studies:

…………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………

16. How did you come to know of Amrita School of Arts and Sciences, Kochi campus?

The Hindu Indian Express Matrubhumi Malayala Manorama

Janmabhumi Kerala Kaumudi Amrita Website Alumni TV Channel

M.A.MATH Matruvani Other Institutions School / Institution last studied

Face book Others (Specify) ______________________________________

DECLARATION BY THE APPLICANT

I ________________________________________ D/o. / S/o. of

hereby declare that the particulars given by me in this Application Form are true. I shall produce the original certificates at
the time of admission. I confirm having read and understood the “Instructions to Candidates” and “FAQ” before filling this
Application Form.

Place: (Signature of the applicant)

Date:
Name: _________________________

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 DECLARATION BY PARENT / GUARDIAN
I, ____________________________________ undertake the responsibility of my daughter/son
_________________________________ who is seeking admission in the Amrita School of Arts and Sciences, Kochi
Campus of Amrita Vishwa Vidyapeetham and declare that the particulars furnished by him/her is correct and true and that
if in future, any information is found to have been furnished falsely or incorrectly or any information suppressed to secure
admission, I shall withdraw my daughter/son from the course without any claim or consideration of the period of
study/stage of the course he/she completed. I hereby ensure that the candidate has read the “Instructions to Candidates” and
“FAQ” before filling this Application Form. I shall not claim refund of fees already paid in the event of discontinuance of
the study.

(Name and Signature of Parents)

Father: _________________________

Mother: ________________________

Name and Signature of Guardian other than Parents (If Applicable):______________________

Relationship with the Applicant:

I fully agree with the above declaration.

I fully agree to abide by the rules and regulations of
Amrita School of Arts and Sciences, Kochi if admitted to
the course.

Place:
Date (Signature of the applicant)

Name: _________________________

FOR OFFICE USE ONLY

Fees Paid: Rs. _________________________ Semester: __________________________

Rt. No. ______________________________ C.D.Rt. No. ________________________

D.D_________________Dt. _____________ Bank. _____________________________

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