The document appears to be an application form for admission to the Foundation Studies Program at Srishti School of Art Design and Technology. It requests personal details of the applicant such as name, date of birth, contact information, education history, academic honors, choice of exam center, and how they heard about the school. In addition to this information, the applicant must submit documents including a demand draft, reference forms, academic transcripts, birth certificate, visa details if applicable, photos, and a personal statement not exceeding 500 words.

1. 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 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 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 Srishti School of Art Design and Technology
Srishti School of Art Design and Technology
Srishti School of Art Design and Technology
Application for
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
Srishti School of Art Design and Technology
Foundation Studies Program
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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
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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
Srishti School of Art Design and Technology 2012-13
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
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
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 Srishti School of Art Design and Technology Srishti School of Art Design and Technology Srishti School of Art Design and Technology
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

2. EDUCATIONAL DATA
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
Details of Employment (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

3. ACADEMIC HONOURS
Briefly list or describe any scholastic distinctions or honours you have won beginning from ninth grade (Std. IX)
PERSONAL STATEMENT
This personal statement helps us become acquainted with you in ways different from courses, grades, test scores, and other
objective data. It will demonstrate your ability to organize thoughts and express youself. Write an essay that will help us know
you better as a person and as a student of art and design. Your essay should not exceed 500 words.
Attach your essay on a separate sheet(s) (same size please)
It must be hand written in black ink. Please write your full name on each sheet.
CHOICE OF EXAM CENTRE (mark any 2 centres in order of preference, eg. 1-Bangalore, 2-Delhi)*
BANGALORE DELHI KOLKATA MUMBAI KOCHI COLOMBO GUWAHATI
*We will try, as far as possible, to give you the centre of your choice.
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