PSAD/ Registration No, Fol No (oes een nts 3 The Monager- DLP Division Date Time aff your recent passport size colour photograph here CC cp ah aye pad Avior Eoin) 298 tami Pe Pakash JE Medical|IIT-JEE| Foundations ‘Aakash Tower, 8, Pusa Road, (ir aac Sree) New Deli-110005 ‘ADMISSION FORM Ps Su [COURSE APPLIED FOR: (Pease mark (V) against the course you wish to app) Distonmbrikeanttaais OF OPO came REO KANDER SP 2 oe 208 (ahaha nt 8 on Anise AG) — OAS Ei de Po—AATS ) ak ut tS On gM eh) a ca ee SseesMaplilEade) 208 | Sees) a Seog Seis 208 cue Gees ees Rao IE Sgr des {Coa vn OP -Cneat oe OtSa ih Po A-ha E-ete S a ne Tt Sr or MTSE BR (neers PY SAS Meta CSP ish Hat "hen ga heen os a} atest ooeyaee ey Respected i, [vant to take admission in your esleered Insitute forthe Distance Leaning Program Course in Engineering Steam marked (7) inthe box. | have read the “Terms & Conditions ofthe Institute even overeat and ages to abide by the same. My particulars are given below: Personal Details Matar fl reared wi ster") Fst Name Lost Name Fater'Guacian' Name Mothers Name Cceupation of Fate Guat (ccupaton of Mater: ate of Btn Gender ur Blood Grup Category (GEN 08/501 S/H atonal Correspondence Address esses ow State Pw Phone (Resiaence Prone (oes: Motlarrt! Set ss EMail 1D Education Details ‘Student las Calgary: |X passed / XI studying 2 studying 1 pases (tease (V) in te rclevant too) ‘School Calage Name & Adres: Marks Obtain: % OCBoard, Se. 8 Mathematics -Agrgate) and/or 5% OG Bard, POM -Aeaegate) ‘eades Obtaine: \cssecua tam. Boo (eB 0SIS0 | | Oe ir canines mention your Aakash Ral No. seston Epi for Scolari se 10% ok 2% 35% otters: How id you com to know about Aakash? Pematens Team ——Nawipaer_——Teches——randaeas——Eeaashins tate Raia ie ‘Sere Place “nape sh rarer wh rt ara ame Pec er NCPR mae. (Siemture of he sadeFor Office Use Only Vere Category of Scholarship. ["ICategory-A [| Category-B CashiDemand Draft No. ‘Amount (8 Drawn on: Date: S.1D/Registration No. Office Receipt No. Date, ‘Admission Place: IBranch [Icentre ‘Terms & Conditions 1 2 10 u. Incomplete Admission Form lb rejected “The duly filed in Rémision Form shouldbe Set Yo the Registered Ofte. Itiscompulsoy to attach seattestad photocopy of mark shea flat sualifying Exam. Itis compukory or students to attach a recent passport size eolou Dhotograph inthe space proved and also staple tree extra colour protographs withthe Raison Form, Institut reserves the nght ta use the singlfaoun photographs] for publicity in case the students) secures position / rank or succes in Engineering Entrance Exams. ‘Students esol in Aakash HT-JEE's OL Course wil have to prove photocopy of Admit Card of JEE (Main & Advanctd) and other EraincerngEnrance Exams as soon as they recive ther admit cards from the eramining body. ‘Students once eal in DLP courses cannot lam for eur af fee or partof the fee; helshe becomes dsintrested during ne course dueto any reason whatsoever. Fee once paid is nt refundable under any Circumstances, The fee includes postagelcourier charges and sevice te Its forthe student to see whether else I eligible for a certain Engineering Eriance Examination or not. The Insitute does nat held itself esporsibe stot’ admision form cannot be forwarded or Isrejected by the examination body on any gound whatsoever, Such a suet cannot claim a refund ofthe whole orany part ofthe fee helshe haspaidtotneinstivte ‘The responsibility of getting admission form forwarded to the examining body that ofthe stent Rimsetherselt er that of the Preis Guaran, the Study materia)Conten proved to the stunts st misplaced ‘once delivered at niser corespondence addres, a duplicate set of Sespate con be obtainect against the payment of ® B00 per cpa, throvgh Demand Draft in favour of Rakash ITEJEE” payabe at New? Dat Ith despatch is retumadto us de to change of adress oor locked non-avaabiliy of adresse, the coure/pstage charges€ 500 wil be charged for sending the cespatch again the said amounts ot pld bythe studentthen estof the despatches wllaiso beheld Info. Centre [-|Promations Executive 12 v. Prov, Receipt No. (it any) [counsellor (Name) Any change ot adress r hone numbers shuld be noted tothe DLP Division without ary delay trough a wtton application or email at dlp@aesLin, cheruise despatches wll be stoppad. Far the change ot [NTS made and Cente, % 500 foreach change wil also be charged from DLP enaled students, Hatany point of time, the Central Govt. futher increases service tx, (existing rate of service taxis 155) the extra amount of serves tax il be bome bythe students fom the date of enforcement ofthe act by the Govt ‘Aakash WTJEE reseres the right to make any alteration in its programs /venue/ timing without ary prior actice. The decision ofthe Diroetoe willbe tinal and binding onthe students a wel asthe parents, The Examination Centve of any place can be changed a6 per the requirement/nesd ofthe company without any prior notice tothe students / parents Hany stent fais to receive the study material within 5.day fromthe date ot despatch, kindly irtrm the DLP Division tlephonicalyat O21 '47623445 163 0cbywrtingan Esai at elp@aest.in Incase of any cispute or diterence between you and nstute regarding the interpretation ofthese terme and cantons, non-payment of any flaim or ary dispute arsing out of orn pursuant to these terms and ‘onctons the same shall be relred fo sole Aratrator who shal be ‘appointed by Charman of Mls Aakash Educational Sevces Prt, “Te proceeding shal be concucte at Now Delhi uncer th provisions of Ablvation& Conliation Act and the Cours at Deli oly shall have ‘he|uissieton over the mater andor for enforcement asthe case may be. an Atitrator to whom the mattr fe refeed refuses to acto ot {any reason, does not enter the reference of after entering into the fefeence proceecings are abandoned or kept in abeyance or nat proceeded with, i shall be lawful forthe Chairman of Mis Aakash Eucational Services Put. Ld. to appoint another person to act as an ‘btrator in the manner aforesaid. Such person shal be enited to prceed with reference flom the stage at which i was lft by his prodocessoy i both the partis consent otis fet, fling which the ‘bitrate willbe ented to proceed ce now, | nave read the Tems & Conlon of AESPL and various pois ofthe Company as mentioned inthe prospects & promise to abide by the sae, (Strats Presson’) *Checklist ooo0o00000 Fourrecentpassportsize sour Photographs aes) Photocopy ofsetatested mar shetof ast qullyng Exar, or Xl as applicable ‘Din favour of kash IT JEE’psyabloatNew Deh (lone tte Suter Centre Code, CetteName and Medium AIA should be propery mentionedon Admission Form. ifyouaveanExAatasian, attach potecpy olden Card ssued by Aakash lang with he Admission For, ‘tach prot ofScholarshinalng with he Aisin Form toavaileoncessin Provide MailD& Mable. fr serdingot formation / SHS. iis compulsory or Parents Guardian andstudetosjgnon Ts & Conitns. Note: tis mandatory for student & parents to sign a he appropriate places falling which admission form wil not be processed and wil be ejected