National institute of music

National institute of music

National institute of music

National institute of music

Application form

application form

NATIONAL INSTITUTE OF MUSIC Post Box 0027, Olavakkode, Palakkad-678002, Kerala, India. Please use the form below to send us your Application. * fields are mandatory.
Personal Details

How did you hear about us? *	:
Name *	:
Age *	:
Date of birth *	:
Mother Tongue *	:
Full address for Communications *	:
Country *	:
State *	:
City	:
Phone *	:
Email *	:

Course Details

Instrument Possessing	:
No. Of Black & White Keys	:
Course selected *	:
Medium of Instruction * (English /Hindi/ Tamil/ Malayalam /Marathi)	:
Employment/Profession :	:

Fees Remmittance Details

DD

Telex Trasfer

Cable Transfer

WUMT

MO

Demand Draft / Money
Order No. & Date *

:

Name of Bank *

:

Branch *

:

Amout in Rs *

:

Bank address *

:

	I do here by confirm that all deals furnished herein above are true. Also I declare that I would abide the rules, regulations and other conditions implied and being in force of the Institute.

+91 9446 23 67 69

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