ADMISSION FORM No:

ADMISSION FORM

1. Name of the Candidate : _____________________________ AFFIX

PASSPORT SIZE
2. Father’s/ Guardian’s Name : _____________________________ PHOTOGRAPH
3. Address : _____________________________
____________________________

Telephone Number : _______________ Mobile: __________________________

e-mail : _________________________________________________
4. Date of Birth : _________________________________________________
5. Educational Qualification : _______________School/College____________________
6. I am planning to rite the entrance examination of the following institutions:

NIFT UG/PG NID UG/PG CEED B. Arch. (NATA) B. Arch (AIEEE)

Pearl Academy Shristi, Bangalore SOFT, Pune Apeejay Institute of design, Delhi

For any other course mention on the space provided____________________________________________

7. I came to know about TAKSHSHILA from:

Newpapers Banners Internet Others

8. You want to join TAKSHSHILA for

Class room coaching Postal coaching

I, ________________________ declare that above information given by me is correct and I will follow the rules
and regulation of the institution. The authority can take disciplinary action in case of misconduct. Fees paid
cannot be refunded under any circumstances.

Date :
Place : Parents/ Guardian Signature Students Signature

FOR OFFICE USE ONLY

Received on _________________________, Registration No. ______________________________________________

Cash/ Bank Draft for Rs. ______________, Name of the Bank and Branch __________________________________
Receipt No. __________________________, Date: ___________________________.
Batch Timings: __________________________________________.
Courses Fees: Rs.

Authorized Signatory