ADMISSION FORM FOR CLASSROOM/HYBRID COURSE

☑ I understand and agree that the personal information will be collected by Aakash Educational Services
Limited (“Company”) while submitting the admission form and the personal information may be used or
stored by the Company as mentioned under the Company’s Privacy Policy. I have read and agree to the
Company’s Privacy Policy in it’s entirety

Form Filled by Parent and I agree that at the time of filling the admission form my age is 18 or above.

PSID: Branch
00009183360 Delhi-Janak Puri Branch

Stream: Term
Medical 2426

Course Name Batch Option

Two Year Integrated Classroom Weekdays-Evening
Course for NEET - 712451

Personal Detail

Student Name: Mehak Shil

Date of Birth 25/01/2008
Gender Female
Category GENERAL
Student Email ID : anubhabsil12345@gmail.com
Primary Mobile No. 9366602698
Secondary Mobile No. : 9233814320
Father’s Name : Ratan Sil
Mother's Name Soma Majunder Shil
Parent's/Guardian's Occupation : Teacher
Nationality : India
Blood Group : A+

Address Details

Correspondence Address

Address: RATAN SIL PO BELONIA VILLAGE SOUTH BELONIA

Pincode: 799155
State: Tripura
City : South Tripura
Phone No :
Parent's Email ID : ratansil1971@gmail.com

Permanent Address

Address: RATAN SIL PO BELONIA VILLAGE SOUTH BELONIA

Pincode: 799155
State: Tripura
City: South Tripura
Phone No: 9366602698

Education Detail

Class Studying: 10
Exam Board: CBSE
School State:
School City:
School Name: Holy Spirit School
Marks Obtained in last class %: %
Grades Obtained in last class: Math : 97

Science : 89

Original marksheet of the last board or equivalent exam

Copy of Identity Card issued by Aakash

Date: 16-11-2023
☑ I hereby authorize the Company and/or its service provider(s) to reach out with transactional/promotional/
other information on my coordinates (whatsapp/ email/ mobile number)
☑ I hereby acknowledge that the information and/or documents provided by me are correct and true. In case of
any discrepancies in the information provided by me, Company shall reserve the right to cancel/reject my
application form
☑ I hereby read, understood and agree the terms and conditions of the Company.

The details of the admission form has been verified by the customer through OTP authentication
on mobile number 9366602698 and 9233814320 at 16-11-2023 18:30:00 at 182.68.94.101