SARVAJANIK EDUCATION SOCIETY

M.T.B. ARTS COLLEGE CAMPUS, ATHWALINES, SURAT

Sarvajanik Competitive Exam Training Cell

ADMISSION FORM
Respected Sir, I, the undersigned seek admission in ENGINEERING ENTRANCE (JEE) / MEDICAL ENTRANCE (PMTGUJCET) INTEGRATED training programme. Please enrol my name as below: Medium : Gujarati I am studying at (Name of School)_____________________________________________________
STUDENTS NAME

FATHERS NAME SURNAME

Mobile Number- Student 91+ PARENT 91+

Email address: (In capital letters)

FULL ADDRESS: _____________________________________________________________________________ _________________________________________________________________________________________ AREA:_________________ SURAT. PINCODE: ______________land-line ph.no:_____-__________________

Date:

/2014
Affix students photograph and sign across the photograph

SIGNATURE: ______________________________

SIGNATURE: _____________________________

(STUDENT) (Terms & conditions on page No.2)

(PARENT)

Page-2

Note: (1) Please submit your application along with cheque of Rs. 12,000 to Shri Ketan Shastri at S.C.E.T College, Athwalines, Surat . Cheque should be drawn in the name of `Sarvajanik Education Society`. TERMS AND CONDITIONS (1) Fees: YOUR FEES SCHEDULE: For First Year Total fees 30,000+30,000=60,000 Rs.12,000 at the time of admission I INSTALLMENT DUE II INSTALLMENT DUE III INSTALLMENT DUE Rs. 18,000 ON 15-06-2014 Rs. 15,000 ON 15-09-2014 Rs. 15,000 ON 15-11-2014

(2) Fees once paid will not be refunded under any circumstances. (3) Timings will be decided by Cell. Student will have to follow the timings. (4) For best result it is in the interest of the students that they attend all classes and do the home assignments as suggested by the faculties. (5) Periodic tests and evaluation exercises will be taken regularly. (6) The course is designed to give training for J.E.E./Medical entrance examinations. (7) Students shall follow rules and regulations of Sarvajanik Education Society. (8) Any student who seek to take benefit of special discount offer i.e. (10%) to Sarvajanik Education Societys students, shall require to furnish school fees receipt of Std.XI. (9) In case of any dispute, Sarvajanik Education Societys Chairmans decision will be final & binding (10) The above fees table includes fees for 1st & 2nd semester only.

I agree to the above terms & conditions.

SIGNATURE: ______________________________

SIGNATURE: _____________________________

(STUDENT) Date: / /2014

(PARENT)

Note: Checklist: 1) Fees Receipt 2) One Extra Photograph 3) S.S.C. Mark sheet-Photocopy/SSC Hall Ticket Xerox