PATHAR

Silver Jubilee Festival — Alumni Registration Form

Celebrating 25 Glorious Years | 15 June 2026 – 15 June 2027 | Established: 15 June 2002

Personal Information

1. Full Name *

2. Gender *

3. Date of Birth

4. Mobile Number *

5. WhatsApp Number

6. Email ID

Address

7. Present Address

Same as Present Address 8. Permanent Address

Details

9. Profession / Occupation

10. Year of Joining Pathar

11. Official Member

Yes No

12. Department / Role in Theatre

Actor / Actress Director Script Writer Music Dance Stage Management Makeup / Costume Light & Sound Volunteer

Other:

Contributions & Memories

13. Memorable Productions / Contributions

14. Pictures / Photos of Plays Performed (optional)

Click to browse or drag files here

JPG, PNG, PDF — max 5MB each

Festival Participation

15. Participation Interest in Silver Jubilee Festival

Drama Performance Cultural Programme Workshop Exhibition Volunteer Service Support

Other:

Sponsorship

Interested in Sponsorship

Type of Sponsorship

Amount / Support Details

Documents

17. Passport Size Photo

Click to upload photo

JPG or PNG, max 2MB

18. ID Proof

Upload ID Proof

JPG, PNG, or PDF, max 2MB

Declaration

I hereby declare that the information provided above is true and accurate to the best of my knowledge. I understand that any false information may result in cancellation of my registration.

Signature / Name of Applicant

Date

Place

Pathar · Silver Jubilee 2026–2027 · patharassam@gmail.com