Odisha Lalit Kala Academy

APPLICATION FORM

All * Fields are compulsory

*Name of the Artist

Passport Size Photo Upload

*Father's Name

*Address

*Date of Birth

Birth Proof Upload

*Mob. No

*E-Mail

*Qualification

Certifiacte Upload

*Category

Medium

*Art work Photo

*Award/Achievements Exhibition Participated

I do hereby declare that the art works are my bonafied original work.

Signature of the Artist