An Autonomous Organization Registered Under Govt. of India
EUREEKA EDUCATION AND SERVICES
An Autonomous Institution Under Assam Trust Act 1882
Admission open for new season 2025-26
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Art & Craft Academy - Admission Form
Select Centre
Center Name
-- Select Centre --
Amguri
Gaurisagar
Halwating
Teok
Selenghat
Other
Other Centre (Specify)
1. Student Information
Upload Image (optional)
Full Name
Date of Birth
Gender
--Select--
Male
Female
Other
Father's Name
Mother's Name
Address
Mobile Number
Email ID
2. Course Details
Course Applied For
-- Select --
Drawing
Painting
Craft
Mixed Course
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
Submit