School/College Name currently attending: ________________________________________________ Medium of Instruction: English / Hindi / Other: ___________ Have you ever failed in any exam? Yes / No (If yes, details): _________________________
Student Name: ___________________ Signature: _______________ Date: __________
SECTION H: OFFICE USE ONLY
I confirm that I have understood the course structure, timings, and code of conduct. I will attend classes regularly, submit assignments on time, and maintain discipline. coaching classes admission form word format
SECTION B: RESIDENTIAL & PARENT/GUARDIAN DETAILS
SECTION E: SCHOOL/OFFICE USE & DOCUMENTS UPLOAD/ATTACHED
SECTION A: STUDENT PERSONAL DETAILS
I, the parent/guardian of the above-named student, certify that all information provided is true and correct to the best of my knowledge. I agree to abide by the rules, regulations, fee structure, and attendance policy of the coaching institute. I understand that the admission may be cancelled if any information is found false.
Father’s Full Name: __________________________ Occupation: ___________________ Mother’s Full Name: _________________________ Occupation: ___________________ Father’s Mobile: ___________ Mother’s Mobile: ___________ Email (Parent): ________________ Annual Family Income (approx.): Below 2L / 2L-5L / 5L-10L / Above 10L Local Guardian (if student stays away): Name: _______________ Contact: _______________
Checklist (Tick & attach photocopies – originals for verification): [ ] Class X Marksheet [ ] Class XII Marksheet (if applicable) [ ] Transfer/Leaving Certificate [ ] Aadhaar Card (student) [ ] Passport size photos (4 copies) [ ] Caste certificate (if applicable) [ ] Parent’s ID proof [ ] Medical certificate (if any disability) SECTION B: RESIDENTIAL & PARENT/GUARDIAN DETAILS SECTION E:
SECTION D: COACHING & COURSE DETAILS
Admission Status: Provisional / Confirmed / Rejected Enrollment No.: ___________ Batch Code: ___________ Fee Receipt No.: ___________ Total Fee: ___________ Paid: ___________ Balance: ___________ Payment Mode: Cash / Card / UPI / DD Counselor Name: ___________ Counselor Signature: ___________ Date: __________ Director/Coordinator Signature: ___________ Remarks: ______________________________