DANCE COMPETITION Application form

KSHETRAKALAVIDYAPEEDAM PERUVAYAL

PROUDLY PRESENTS

                       MEGA FREESTYLE DANCE COMPETITION

ON 2015 MAY 1,2 AND 3

Application form

Name of the Troupe            :
Name of the Troupe Leader :
      Address                        :



      District                        :
      State                            :
      pin                               :
      phone (land line)          :
      Mob. :

No. of participants in the troupe :

Troupe manager                  :

          Contact address         :

         phone number            :

         any other contact no.  :

Mode of registration            :  Direct  / E-mail

Mode of registration fee paid: Direct  / thorough bank counter
(if paid through bank counter E- mail the receipt scan copy to us)***

Troupe need any thing on background other than colour light : yes / no

If yes which one do you want : curtain(s) / video projector / LED display *

Troupe need accommodation in kozhikode city : yes /no **

If yes, affordable rate of the room in between :₹              to   ₹

(* Background other than colour light is not resposible for the organisers
** Organisers book the room(s) if you wish and not responsible for the rent or comforts in it.
***Reg. fee  ₹ 5000 can pay  in favour of Kshethrakalavidyapeedam Peruvayal payable at SBI poovattuparamba, SB no. 34808161583, ifsc code is SBIN 0012195 )

(N.B.  Read Terms and Conditions before filling the application form)

contact no.s  9446339516,   9847098399, 9447454314, 9447245179

EMAIL: kshethrakalavidyapeedam@gmail.com



Dance troupe members


Sl. No.        Name                      m/ f     Age   Address  with phone no.  

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team manager: