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Tachyons classes

Ph. 09729983483,7876379402 E-mail

Registration/Enrolment Form
FOR OFFICE USE ONLY
Registration No. .
Receipt No. ..
Fees Deposited:

Cash/Cheque (Details):

APPLICATION INFORMATION
1. Name (Use CAPITAL Letters)
2. Date for Birth Age as on: ..Yrs.
3. Gender:

Male

Female

4. Fathers Name ..
5. Fathers Profession..
6. Full Address: Permanent: .
..Pin.
Ph: ..Mob.
Ph: ..Mob. ..
7. Educational Qualification:
Examination

Name of
school

Board/Univ.

Year of

% age

Subject

passing

Class VIII
Class IX
Class X
Class XI
Class XII

8. Mention the year in which you had completed your last examination: .

9. Have you appeared in the IIT/JEE Examination earlier? If yes, Give details:

10.Are you:

Student

Employed

Self-Employed

11.Have you ever been awarded any Scholarship (Give details) .


..
12.I hereby declare that all informations provided by me in this application form are true,
complete and correct to best of my knowledge and belief. In the event of any information
being found false and incorrect, my admission shall be cancelled at any stage.

Date:

Signature ..

N.B.: 1. The decision taken by the Academy on your above application for admission shall be
final and binding.
2.

Fee once paid will neither refund nor adjust under any circumstances.

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