RANI CHANNAMMA UNIVERSITY, BELGAVI CHANNAMMA SAMBRAMA UNIFEST 2011-12 NAME OF THE COLLEGE: KLS GOGTE COLLEGE OF COMMERCE,

BELGAUM NAME OF THE ITEM: MUSIC/ DANCE/ THEATRE/: LITERARY/ FINE ARTS S.NO. 1. 2. 3. 4. 5. 6. 7. 8. 9. 1 0. NAME OF THE PARTICIPANT STUDENT/ PROFESSIONAL DATE OF BIRTH NAME OF THE SUBITEM AND TYPE NO. OF ITEMS OF PARTICIPATION IN THE YOUTH FESTIVAL REMARKS _______________ ANNEXURE- IV

Date: 17-04-2012 Place: Belgaum Note: 1. Use separate forms for each main item 2. The Fine Arts Material Musical instruments and make up material should be traoght by the participants. Signature & Name of the Cultural Co-ordinator