EUREEKA INSTITUTE OF COMPUTER AND FINE ARTS

EUREEKA EDUCATION AND SERVICES

An Autonomous Institution Under Assam Trust Act 1882

Admission open for new season 2025-26

Art & Craft Academy - Admission Form

Select Centre

Center Name

1. Student Information

Upload Image (optional)

Full Name

Date of Birth

Gender

Father's Name

Mother's Name

Address

Mobile Number

Email ID

2. Course Details

Course Applied For

Preferred Batch Time

Admission Date

3. Educational Details

Present Class / Qualification

School / College Name

4. Emergency Contact

Name

Relation

Phone Number

5. Medical Information

Any illness / allergy?

6. Declaration

I hereby declare that the information provided above is true and correct. I agree to follow all the rules and guidelines of the Art and Craft Academy under EUREEKA EDUCATION AND SERVICE.

Signature of Student (upload image)

Signature of Parent/Guardian (upload image)

Date