Affix passport size
color photograph here
and attach 1 additional
photograph to the
application form
NATIONAL SCHOOL OF DRAMA
Bengaluru Chapter
Guru Nanak Bhavan. No. 6
Tank Bund Road, Vasanthanagara, Bengaluru-560052
ONE YEAR INTENSIVE COURSE IN ACTING
(2014-15)
APPLICATION FORM
Name in full ( ( in block letters ) Shri / Smt./ Km._____________________________________________
Date of Birth ____/___/_____ Age as on 1/8/2014 __________ Years ___________ Months________
days_______ Nationality _________Male ___ Female _____
Present Address ( In Block letter)________________________________________________________
City ____________ Distt._____________ State ___________________ Pin _______ Phone__________
Permanent Address ( In Block Letter)______________________________________________________
City ____________ Distt._____________ State ___________________ Pin _______ Phone__________
Emergency Contact No. _____________________ E -.mail _____________________________________
Mothers’ Name ______________________________ Father’s Name ____________________________
Fathers’ / Mother’s profession and his /her annual income ____________________________________
Whether SC/ ST/ OBC /( attach documentary proof duly verified )_______________________________
Married / unmarried ___________________________ Number of children, if any__________________
Academic Qualification (attach attested copies)
Board / degree Year University / Board/ Institute Main Subject % of Marks obtained
High School ______ _____________________ ___________ __________________
Intermediate ______ _____________________ ___________ __________________
Graduation ______ _____________________ ___________ __________________
Post Graduation ______ _____________________ ___________ __________________
Training, if any ______ _____________________ ___________ __________________
Experience in Theatre (Separate sheet/s can be attached)
Play/s workshop/s Directed by / conducted by Duration Organization Your participation as
_______________ _______________________ __________ _________ __________________
_______________ _______________________ __________ _________ __________________
_______________ _______________________ __________ _________ _______________
______________ _______________________ __________ _________
________________________________ _______________________ __________ _________
Other Qualifications / Experience
Dance , Music ( Vocal/ instrumental ) or Visual Art
_____________________________________________________________________________________
_____________________________________________________________________________________
Purpose of Joining the course is (Give detailed description in 20 lines on a separate sheet)
State of Health
(i) Are you physically fit to undertake theatre practice for long hours? __________________
(ii) Have you undergone any training in physical fitness? if so , mention it _________________
(iii) Mention your height and weight_______________________________________________
I am enclosing herewith DD.No. ___________ of Rs 100/- dated _________________ issued by the
bank _________________( Nationalized bank) favoring NSD, Bengaluru Chapter.
I agree to abide by the rules & regulations of National School of Drama, Bengaluru Chapter and fulfill all
the responsibilities assigned to me .
____________ __________________
Date Singnature of Candidate
Note:-
1. Please send your application in an envelope titled “Application for aforesaid diploma 2014-15 by
Post Or directly submit to the Camp NATINAL SCOOL OF DRAMA, Bengaluru Chapter, Guru
Nanak Bhawann. No. 6 Tank Bund Road, Vasanthanagara, Bengaluru-560052
2. Please attach 2 reference of the theatre personalities recommending your candidature
FOR OFFICE USE ONLY
Interviewed on_______________________________________________________________________
Report of Interview __________________________________________________________________
Admitted /not Admitted_______________________________________________________________
Director
National School of Drama
