SIDE1 farts] India Best institute for IS, GATE & PSUs e- ADMISSION FORM = For office use only = ROLL APPLICATION = NUMBER NUMBER = CANDIDATE'S NAME (IN BLOCK LETTERS) DATE OF BIRTH ‘QUALIFYING DEGREE = OOOOOOSO0ORO00000000009} |OOO000} |OCFjOOOOoO; = 99HHHHHHHHHHHOHHHHHHSHSSS| |GOSOGG| |x |GodoSo| = ®OGOOHQGHDDHOHHOHGHOQOOHGHOSG | |@0G2Go| Jor |@ooo;oo| = ®OOGOOGHOOHOOOOHOHOGHOGSGSG| |@® oG0| box |aeaeoo| = DOODODHOHHOHOOHOHOHOHSGGG| |@® o90| |ox |@ooooo| = G©GSGOGSGOHSSSOOHCG®OGS| |@© @G0| |oam|aooaoo) — OHOOGGOGBGOGHHBGHHOHGHOHOHOHSG| |@© Go| |on |aooooo| = GVHHGQHHOHOQHGOHOHOGOGGG| |©O O00] lor |@ooooo| = QOGGODOH®GOA®GHOHOAOOAGHG | |OO DOO] | Dore |[OoD2oo] = DOODDOHODHHOHODOOOOHHOGDOG | |G OOo ooooo| = DDHODHDHDODODDOOHODGIOG | [Oo 9O@ sooopo; = QOGOHLODODHOHDOOOWQOLHOOLWO®W - DOOOSODOOOOOLOODOOOOOOOS | [EATERS OCCUPATION PROGRAM CODE = DOHOODOOOHOOOODGOODODD HDD | [@conenpowecass | |i Rewrcwwoncane | mm DOODOODODODHOHOGOOOAOSDODDD| | |@ coenyeecass | | @ wesendcaseroncare | DOGODHHOHOGGGHOGDODOGHGOG | | @ieaemplopeciss2)| | coxwontowswes - DOOOOGPHOOOHOHOQOHQOGOHHG | | @ cow. empioye cases || Post tesrsees = QOD ODOODGDOD ADO DOODOODGHOD @ Private Job ®@ GS. 8Eraish -_ QOQODODODOHDOHQODOHOHDHOSDOS | | O owe @ himinn cure = 9999DHDOGOQOHOHHOHOHSGOG | |@revsners —— = DOOOOOOOHOHOOOGOOOHOHOO | | 0 Fars @ Genera = DOOODGHHOHOHOGHOGODOGOGO | |@rrencing rose - DOOOCOVOPGWOGHOHHOOHODOHDOGDO® | |@ omen @ se = @®Q0HLDHHOHOHQOHOBOBOHOD = ost = DQDQODODODODODODODOOHODOD = DYOVYOOOYOOWOGOGHOVOHHOHYO® |_| uronase WADEEASYCENTRES | om DVWVDWOHHOHODOHOGODOHODOG | [O mw © Doh - @ Hyseraboa = MOBILE NUMBER (10 digits) PERSONAL DETAILS (N CAPITAL LETTERS) @ Noite = @UOO0000000 her’ ® Bhopal - SDOODDOODOHOD Father's Name: @® Jaipur - ®D®DODDDAVO | | Father's Designation ® Locinow = ®®QOOQO®ODOO® | | Father's contact No. Dear - DOODOHHHHA | | present Addross: @ endeneenar = ®OO9OD9OSO "Pine = DOOOOODOOOD “en ae ® Kolkata - DOODOHOSOWO | | errors -Pin OO) = DBOHHHHOHO®O | | Student’s E-mail 0: sssuennnns = DOODOHOHOOD Phone (with STD Code): - DHODODOHD® ns = BATCH TIMING PREFERENCE passport size = rotograph Moning © Atenoon Dievenngi | eaeh code oto = Corporate Office: 44-A/1, Kalu Sarai (Sarvapriya Vihar) New Dethi-110016 (00 Nor STAPLE) = Ph: 011-45124612 | Website: www.madeeasy.in = Wrong Mthod Wong thod =< Wong Method —=«—«Wong Method = Garect Method = (oeO0) [@oo) (6@o0) = IMPORTANT : USE BLACK/BLUE BALL POINT PEN ONLY. e=SIDE 2 EDUCATIONAL DETAILS (IN CAPITAL LETTERS) Branch of Engg. ] Degree Name of College & City Passing Year |% Marks PROOF OF IDENTITY (Submit self attested copy of ID proof) (ln absonce of ID proof of candidate, father’s Kdeniyladdress praof can be submited) Passport Election |-Card Driving License Aadhar Card College I-Card PAN Card Others (Specify) Oo Name of the card holder: ______________ Card No. Checked by (for office use); _____________Signature (for office use): PERMANENT ADDRESS (IN CAPITAL LETTERS) city State: Phone (STD Code): ..... .. Pin: DEMAND DRAFT | DD No. | Amount Bank Name cy DETAILS Rules & Regulations (a) Every students expected to mainlan decpine within aur campus n eae of violation of any ofthe rules & regulations ‘or discipline, the intite reserves the righ to dsenrall any student without any refund of fes, (b) Allstudents are requested to bring their dontiy cards dally for attending the classes & collecting study materials (@) MADE EASY reserves the right to make any alterations ints programmesieesfaculyivenue of classes without any pric notice to anybody However all the changes wil bs informed fo the students accordingly (6) The batch once allotted atthe time of admission wil nat be changed. {e) Students enrolled under classroom courses will not be transferred or shied to postal course or vice-versa, (0) MADE EASY studonts are requires to submit a photocopy of thoi IES & GATE admit cards, (6) _Itis mandatory o attach two photographs & a copy of 1D proof withthe form at the time of admission, The name and photo of cansidate may be published n thelist of successful candidates in current o future seesions. (h) Candidates who aval te factly to pay the fes in wo installments willbe chargee Rs. 2500 extra within 45 days of commencement of batch. (1) _Instalment charges wil be immediately applicable once student have taken admission and opted for “Installment Payment Scheme", (i) Admission fee is non-efundable under any circumstances, (k) The foes wil bo refundable only within 5 days fram commencement of batch after deducting admission foes. (0) The student can replace hither seat by @ new student within frst 3 months ofthe commencement of batch, subjected to replacement charges of Rs. 5000. This option can be availed by students only when refund option is not available. UNDERTAKING 4 Is applying for admission to program * | certify thatthe information given by me is true to the best of my knowledge and belief. | understand that if anything is found falselincorrect at any stage, my admission to the course shall be cancelled without any refund of fees, * | shall abide by all the rules and regulations of MADE EASY | will have no objection on publication of my photo by the institute after ‘my selection in the compatiive exam and the institute willbe entiled to use my photo and admission details for its advertisement purpose, | have enclosed the self-attested copy of ID ProoffAddress Proof Date Place Signature of the Candidate ¥ Note: This part should be filled by the guardian only, in absence of the candidate. 1 . of. (Guardian Name) ‘Relationship of Candidate) (Cancldates Name) hereby declare that have competed all the fmaliies on behalf he candidate. Ihave read and understood all the terms and cantons of MADE EASY. Guardian's Dater Mobile No. * Signature of the Guardian