The 45th ALL INDIA COMPETITIONS IN MUSIC AND DANCE, 2013 (This form duly filled in should reach the Organising Secretary, Navya Nataka Samiti, # 1-8-522/12, Chikkadpally, Hyderabad - 500 020 or the Y.M.C.A., Narayanguda, Hyderabad - 500 029 on or before the 20th November, 2012 ENTRY FORM 1. Name in full (in Block Letters) : Sri / Smt. / Kum.________________________________________________ 2. Address with Pin Code ___________________________________________________________________ ___________________________________________________________________Pin : ______________ 3. Age and Date of Birth____________________________________________________________________ (Proof of age to be produced) 4. Contact No.: ___________________________________________________________________________ 5. Branch and Section in which the entry is made : ______________________________________________ (Tick the appropriate item) 1. Karnatak - Vocal - Senior 11. Bharatanatyam - Senior 2. Karnatak - Veena - Senior 12. Bharatanatyam - Junior 3. Karnatak - Violin - Senior 13. Bharatanatyam - Sub - Junior 4. Karnatak - Mridangam - Senior 14. Kuchipudi - Senior 5. Karnatak - Vocal - Junior 15. Kuchipudi - Junior 6. Karnatak - Vocal - Sub-Junior 16. Kuchipudi - Sub-Junior 7. Hindustani - Vocal - Senior 17. Andhra Natyam - Senior 8. Hindustani - Sitar - Senior 18. Andhra Natyam - Junior 9. Hindustani - Tabla - Senior 19. Andhra Natyam - Sub-Junior 10. Hindustani - Tabla - Junior 20. Kathak - Senior 21. Kathak - Junior Entry fee remitted : Seniors / Juniors / Sub-Juniors Rs.100/- by Cash / MO / DD drawn in favour of Navya Nataka Samiti, Hyderabad. Specify particulars in Money Order Coupons clearly. Name of the Guru / Institution and Address : _______________________________________________________ ______________________________________________________________________________________________ DECLARATION I declare that I will abide by the Rules and Regulations of the Competitions. Signature of the Parent / Guardian Signature of the Competitor (in case of Minor) FOR OFFICE USE ONLY Place : Date : NOTE : 1. There is no objection to a Sub-Junior Section competitor taking part in Junior or Senior Section or a Junior Section Competitor in Senior Section and not vice versa. But, no Competitor can take part in more than one section in the same branch. 2. Competitors are advised to keep proof of age with them for production. Otherwise the entry is liable for disqualification..