Professional Documents
Culture Documents
A I E E E
P M T
Affix your
recent passport
size photographs
here
ENROLLMENT FORM
To,
THE ADMISSION INCHARGE
FOUNTAIN INTERNATIONAL COACHING INSTITUTE
7/C, Taimoor Nagar, Near Gurdwara,
New Friends Colony, New Delhi 110065
BATCH OPTION
Regular Classroom
Weekend
I wish to take admission in your institute for Classroom Program Course marked in the box. I have read the
Terms & Conditions of the institute given overleaf and agree to abide by the same. My particulars are given below:
(Please fill the form in CAPITAL LETTERS)
First Name
Last Name
Fathers/Guardians Name
Mothers Name
Fathers Occupation
Designation
Category
Gender M F
Date of Birth
Blood Group
Residential Address
City
Pincode
State
Phone
Fax
(STD Code)
(Number)
Mobile
(Any Other)
(STD Code)
(Number)
(Students)
Correspondence Address
(Please ignore if same as Residence Address)
City
Pincode
State
Phone
Fax
(STD Code)
(Number)
(Any Other)
(STD Code)
(Number)
CBSE
UP/UT
ISC
XI appearing
5%
Any Other
XII appearing
10%
Date:
Place:
20%
Mktg. Team
XII passed
30%
Newspaper
40%
Teacher
50%
Friends
100%
Radio
Website
(Signature of Student)
PAYMENT DETAILS
Sr. No.
Date
Receipt No.
DD/Cheque No.
Amount (Rs.)
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.