sri padmavati mahila visvavidyalayam tirupati, …sri padmavati mahila visvavidyalayam, tirupati...
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SRI PADMAVATI MAHILA VISVAVIDYALAYAM Tirupati, Andhra Pradesh, India
and SUSWARA ACADEMY OF MUSIC
Dallas, TX, USA
Application for Admission of students into Advanced Diploma in Music through Suswara Academy of Music, USA
I. Applicant Information
1. Student First and Last Name : ______________________________________________________
2. Date of Birth (mm/dd/yyyy) : ______________________________________________________
3. Name of Parent/Guardian : ___________________________________________________
4. Mailing Address : _______________________________________________________
_______________________________________________________
_______________________________________________________
5. Phone : +1 _________________________________
6. Email : ______________________________________________________________________
II. School Information
7. Name of Teacher/ School : Mrs. Meenakshi Anipindi / Suswara Academy of Music
8. City/ State/ Country of School : McKinney, Texas, U.S.A.
III. Programme Information
9. Music Level : I II III IV
10. Date enrolled (mm/dd/yyyy) :
11. Cheque # _______________________ (Payable to Suswara Academy of Music. Ref: SPMVV Exam).
For Office Use Only
Chairman : Mrs. Meenakshi Anipindi Email : [email protected] Phone : +1 (214) 649 8278 School Address: 8951 Collin Mckinney Pkwy, Suite# 1102. McKinney, Texas. 75070, United States
___________________________
(Use CAPITAL letters for Names)
SRI PADMAVATI MAHILA VISVAVIDYALAYAM, TIRUPATI (AP), INDIA(Women’s University)
Accredited with ‘A’ GRADE by NAAC
Application for admission to the WRITTEN examination ADVANCED DIPLOMA IN MUSIC (INTERNATIONAL PROGRAMME)
Month and Year of Examination :
Examination Centre :
Candidate First and Last Name :
(USE BLOCK LETTERS) as mentioned in the application
1. Name of Parent/ Guardian :
2. Date of Birth & Age :
3. Nationality :
4. Permanent address for Correspondence:
Phone :
Email :
5. Name of the Institution : Suswara Academy of Music, McKinney, Texas. USA.
6. Name of the Course & Level :
(Strike off whichever is not applicable)
7. Date of Registration8.
9.10.
Affix Photo duly attested
by the identifying officer
NOTE Incomplete application or application with
insufficient examination fees will be summarily rejected.
For Office Use only
Hall Ticket # : Exam Centre :
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Whether the candidate has taken : Year: Hall Ticket #: Written examination before Month:
__________________ ____________________
YesNo
If so, the result of that examination : Particulars of fee paid :
STATION:
DATE: Signature of the Head of the Institution_________________________
_________________________
________________________________
____________________________________________
Pass Fail
SRI PADMAVATI MAHILA VISVAVIDYALAYAM, TIRUPATI (AP), INDIA (Women’s University)
Accredited with ‘A’ GRADE by NAAC
DUPLICATE HALL TICKET
(Entries to be filled in by the candidate and sent along with the application) ADVANCED DIPLOMA IN MUSIC - WRITTEN EXAMINATION
1. Candidate’s full Name: 2. Course & Level : ________________________________ Signature of the Course Coordinator UNIVERSITY OFFICE, Tirupathi, AP.INDIA. Signature of the Candidate Date:______________ Controller of Examinations & SRI PADMAVATI MAHILA VISVAVIDYALAYAM, TIRUPATI (AP), INDIA
(Women’s University) Accredited with ‘A’ GRADE by NAAC
ORIGINAL HALL TICKET
(Entries to be filled in by the candidate and sent along with the application) ADVANCED DIPLOMA IN MUSIC - WRITTEN EXAMINATION
1. Candidate’s full Name: 2. Course & Level : _______________________________ Signature of the Course Coordinator: UNIVERSITY OFFICE, Tirupathi, AP.INDIA. Signature of the Candidate Date:_____________ Controller of Examinations
Affix Photo duly attested by the identifying officer
Affix Photo duly attested by the identifying officer
H.T.No.:
H.T.No.: