Online Application Form



1. PERSONAL DETAILS

Full Name ( as per NRIC ) * Required

Gender * Required
Date Of Birth * Required

Address * Required

E-mail Address * Required

Mobile Number (eg: +60123456789) * Required

NRIC / MYKID / Passport No. (eg: 990101015555) * Required

Occupation

How did you get to know about Sugam Karnatica ? * Required

Have you learnt Carnatic Music before? If yes, Please specify details (where and what)


Class Type
    Physical Class     Virtual Class
Preferred Day

Uniform Size

Courses offered at SUGAM * Required
Please Tick (✔) at least 1 Course

ZIZU
Beginner (3 yrs old) Intermediate (4 yrs old) Advance (5 yrs old)
Pre-grade (6 yrs old)
 
GRADE CERTIFICATE (7 TO 15 YEARS OLD)
Classical Arts
Sangeetham Violin Veena
Harmonium Mridangam Tabla
Flute Bharata Natyam
 
Creative Arts
Creative Writing Visual Arts Theatre
 
Languages
Tamil
 
CERTIFICATE (16 TO 17 YEARS OLD)
Sangeetham Violin Veena
Harmonium Mridangam Tabla
Flute Bharata Natyam
 
DIPLOMA (18 YEARS OLD & ABOVE - min SPM or equivalent)
Vocal Violin Veena
Mridangam Bharata Natyam
 
DEGREE (18 YEARS OLD & ABOVE - min STPM or equivalent)
Vocal Violin Veena
Mridangam Bharata Natyam
 
ACADEMIC QUALIFICATION
SRP/PMR/PT3
SPM/O-LEVELS/EQUIVALENT
PRE-U ie. STPM/A-LEVELS/EQUIVALENT
DEGREE
MASTERS
PhD
Registration Fees
Registration RM 120.00
Uniform RM 75.00
Music Carnival RM 50.00

TOTAL FEES RM 245.00
Medical History

Brief Medical History

Allergies

Do you have any other special condition (eg: Color Blind)



2. PARENT DETAILS


FATHER DETAILS

Full Name ( as per NRIC ) * Required

NRIC

Occupation

E-mail Address

Mobile Number (eg: +60123456789)


MOTHER DETAILS

Full Name ( as per NRIC ) * Required

NRIC

Occupation

E-mail Address

Mobile Number (eg: +60123456789)



3. Emergency Contact


EMERGENCY CONTACT

Full Name ( as per NRIC ) * Required

Relationship * Required

Mobile Number (eg: +60123456789) * Required