JET 2019

Application Form

FTII, Pune
SRFTI, Kolkata

220793
* Application No.

* Course(s) Selected Acting

Test Centre Details

Preference 1: Chennai
* Date of Written Test 24th February 2019 (Sunday) * Test Centre City Name
Preference 2: Bengaluru

Personal Particulars
* Name TANAY AGRAWAL
* Mother's Name Sapna Agrawal * Father's Name Sunil Agrawal
* Date of Birth 25-Sep-1998 * Category GEN
* Gender Male * Nationality INDIAN
* Are you person with disablity (PwD)? NO
* Address for Communication 706 Manglaytan Apartment
Jain Mandir Road
Kota Jn.
Kota
Rajasthan-324002
  Email-ID tanayagrawal80@gmail.com   Alternate Email-ID
  Contact No. +91 -7976004165 * Mobile No.: 8107470173

Qualification Details:
Percentage/
Qualification Qualification/Degree Board/ Main Subjects/ Marking Exam Year of
CGPA/ Division
Level Name University Specialization Scheme Status Passing
Grade
English, Science,
Secondary School
10th* CBSE Social Studies, CGPA - 2014 07
Certificate
Hindi, Maths
10+2/ Maths,
Higher Secondary
Equivalent CBSE Commerce, Percentage - 2016 64
Certificate
Diploma * English
Food Production,
Food &
Beverages, Front
Graduation* H&HA IGNOU Percentage Appearing 2019
Office,
Accommodation
Operati
Any Training: Did internship in 4th Semester(27-11-2017 to 23-03-2018) from J.W. Marriott, Juhu, Mumbai. Took Acting workshop held by
Evam theatre group, Chennai, in June, 2017.
Extra Information: I have been doing theatre plays since I was in school. I will be acting in a Shakespeare play (Julius Caesar), to be put on
by The Madras Players, Chennai from 01- 03 March, 2019, at Museum Theatre, Chennai.

Mode of Payment: --> Credit/Debit Card

* Transaction Reference No. 14161862 * Payment Date 1/14/2019 4:30:03 PM
Receipt No/ 901422408228/
* * Amount 4000
PG Ref.No. 2090019304

I hereby agree to the JET 2019 guidelines and affirm that the statement made and information furnished by me in the Online Application Form is true,
complete and correct to the best of my knowledge and belief. In the event of any information being found false or incorrect or ineligibility being
detected before or after the examination, my candidature will be rejected and action can be taken against me. I have read the JET- 2018 information
bulletin carefully and I hereby undertake to abide by the same. I further declare that I fulfill all the conditions of eligibility regarding educational
qualifications, etc. prescribed for FTII/SRFTI admissions.

You are NOT required to send Application Form/any documents/receipt to FTII/SRFTI.

Place

Date Signature of Applicant

(Application submitted on Monday, January 14, 2019 16:33)
(Please Print the form for further reference)