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AUDITION FORM FOR “THE REAL CHAMPION OF JHARKHAND – 2019”

APPLICATION FORM

NAME /NICK NAME :......................................................................................

FATHER’S NAME :......................................................................................

MOTHER’S NAME :......................................................................................

PERMANENT ADDRESS:......................................................................................

……………………………………………………………………………………….
ADDRESS FOR
CORRESPONDENCE :......................................................................................

……………………………………………………………………………………..

TELEPHONE/Mobile :......................................................................................

E-MAIL :......................................................................................

SCHOOL/COLLEGE :......................................................................................

CLASS :......................................................................................

D.O.B (attach proof)/ Age :......................................................................................

CATEGORIES IN WHICH PARTICIPATING :( PLEASE TICK)

A) JHARKHAND SINGING STAR

B) JHARKHAND DANCING STAR

C) MR JHARKHAND ( 2 Full Length & 2 close Ups Photographs)

D) MISS JHARKHAND ( 2 Full Length & 2 close Ups Photographs)


AGE AS ON 30TH NOV.2019 :..............................HEIGHT.:.............WEIGHT.:...............

HOBBIES AND INTERESTS:......................................................................................

FUTURE GOALS :......................................................................................

ALLERGIC/MEDICAL CONDITIONS
WE SHOULD BE AWARE OF :......................................................................................

YOUR PHYSICIAN’S NAME :........................................................TEL.:.......................

UNDERTAKING

We do hereby declare that all statements made and particulars given by me in this
application are true, correct to the best of our knowledge and belief.

Signature of the Applicant :

Signature of the Guardian :

Signature of the Principal/Head Master/Head Mistress:

(With Seal)

(Application is incomplete without Photocopy of Birth Certificate as described in bi-law)

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