Srishti application-professional-diploma-2012

Srishti School of Art Design and Technology Srishti School of Art Design and Technology Srishti School of Art Design and Technology Srishti School of Art Design and Technology
Srishti School of Art Design and Technology
Application for
PASTE A RECENT COLOUR
Professional Diploma Program
PHOTOGRAPH HERE
Srishti School of Art Design and Technology 2012-13

Please type or print in black ink. Mail the completed application forms with the completed reference form to the Srishti Admissions Office

Office use only APP. DATE APP. NUMBER

PERSONAL INFORMATION
Name
first middle last

Date of Birth Place of Birth
DD MM YYYY

Permanent Home Address

Tel No. Mobile Email

Preferred Mailing Address (If different from above)

Father’s Name Mother’s Name

Occupation Occupation

Office Address Office Address

Tel No. Mobile Tel No. Mobile

Email Email

Citizenship Indian Other (Please Specify)

Local Guardian’s Name

Address

Occupation Tel No. Email

Srishti School of Art, Design and Technology
P O Box No. 6430, Opp. Wheel and Axle Plant, Off Doddaballapur Road, Yelahanka New Town, Bangalore 560106, Karnataka
Tel: 080 40447000 / 40446964 / 65 / 66 Telefax: 28560950 Email: admissions@srishti.ac.in Website: srishti.ac.in

EDUCATION BACKGROUND

List of Secondary Schools / Colleges you have attended. Please start with most recent first
Date Institution and Location Marks/Grade (%) Board of Exam
in Exam Passed State/ ISC/ CBSE/IB/ ‘A’ Level/ Others

Employment History (if any). Please start with most recent first
Date (From-To) Name of Organisation & Address Job Description & Position Salary / Income

Extracurricular, Personal and Volunteer Activities
Activity Approximate time spent Position held or Honours earned

PERSONAL STATEMENT:
Please write a personal statement outlining your interests, motivations and skills that you feel are relevant for your application
(in no more than 500 words)

ACADEMIC HONOURS
Briefly list or describe any scholastic distinctions or honours you have won beginning from ninth grade (Std. IX)

DIPLOMA PROGRAM IN
Please indicate the desired program path.

Design for Business Design for Humanity Design as Experimentation

DESIRED MAJOR
Please indicate the desired major.

Furniture & Interiors Design Textile & Surface Design Product & Interface Design

Visual Communication Digital Video Production Animation & Visual Effects

I HEARD ABOUT SRISHTI FROM
Friends or Relatives Print Ad Internet Search
(specify publication) (specify search engine)

School Counsellor Internet Ad Other (specify)
(specify source)

APPLICATION FEE
DD enclosed

DOCUMENTS AND OTHER REQUIREMENTS
Please submit the following with this form:
1. A Demand Draft favouring "Srishti" for Rs.2500/- (non-refundable processing fee),
payable at Bangalore, with your name clearly written on the reverse
2. Open reference forms fully completed and signed by the referee (two references required)
3. Copies of your most recent mark sheets / transcripts
4. A copy of Birth Certificate
5. Details of Visa (if you are not of Indian origin)
6. Two recent colour passport size photos
7. Personal statement (as mentioned earlier)
Please note that material submitted will not be returned under any circumstances.

SIGNATURE
I certify that all the information in my application is factually true, and honestly presented.
The personal statement is my own work.

Signature Date

Srishti application-professional-diploma-2012

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