Enr o l m e n t F o r m

(for Classroom / Integrated School Programs)

Enrolment Number (for official use only)

In order to serve you even better, please share your valuable opinion below

What has influenced you the most to join FIITJEE ? {Pls tick () options relevant to you}
FIITJEE Results / Achievements 
FIITJEE Value System

FIITJEE Faculty

 if yes, Name of FIITJEE Faculty : .........................................................................................

FIITJEE Student

 if yes, Name of FIITJEE Student : .........................................................................................

His / Her FIITJEE Program Name : .........................................................................................

FIITJEE Study Centre Enrolled at : .........................................................................................

If any other influence (please specify) : ............................................................................................................................

.............................................................................................................................................................................................

u
Instruction for filling Enrolment Form
Please read carefully the Important Information for Students (& their Parents / Legal Guardians) and Declarations / Undertakings section on
page no. 9, 10 & 11 respectively before filling this Form.

Please Note :
v Check the availability of the program at your preferred FIITJEE centre before making a choice.
v Make a photocopy of this form after filling the required information and before submitting it to FIITJEE.
v Log on to www.fiitjee.com/regupdate.htm to update your Contact Details online using Registration Number and web access code printed

on your Hall Ticket.

Items required to be submitted along with this form :

v Six identical passport size colour photographs of the student (One photograph should be pasted on this page, Two on page no. 13 and

Three photographs should be submitted along with this Enrolment Form).

v One stamp size photograph (should be pasted on page no. 13).

v Admission Test / FTRE / FTSE / Fortunate - 40 Hall Ticket (in Original).
v Admission offer letter (in Original).
v Any one of the following documents :
n Photocopy of School ID card with photograph or

n Photocopy of last Board or School Marksheet supported by any Identity Proof of student or

n Photocopy of Transfer Certificate or

n Bonafide certificate issued by the Principal of School with students photograph
Original should be presented for verification at the time of admission.

Enrolment Form

Test date : ______/______/_____________

Registration Number (as mentioned on the Hall Ticket) :_______________________________________________

Study Centre

Please affix the

1st passport size colour
photograph of the
student here

: _________________________________________________________

Program Name (refer page no. 13 & 14)

: ________________________________________________________________________

Program Code (refer page no. 13 & 14)

: ________________________________________________________________________

Scholarship Awarded % (if applicable)

: ________________________________________________________________________

Students Name (in Block Letters)

: _______________________________________________________________________________________

Date of Birth

: ________/_______/___________ E-mail ID :_________________________________________________

Mailing Address

: _______________________________________________________________________________________

________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
_________________________________________________________________________________ Pin : _________________________________
Contact No (Mobile) : ____________________________ Land Line (with STD Code) : ___________________________________
Permanent Address (if any)

: _______________________________________________________________________________________

________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
_________________________________________________________________________________ Pin :_________________________________
Contact No. (Mobile) : ____________________________ Land Line (with STD Code) : ___________________________________
School/College Last Attended / Presently Attending : _____________________________________________________________________
Address

: _______________________________________________________________________________________

_________________________________________________________________________________ Pin : _________________________________

(a) Fathers Name

Occupation

Business 

: ________________________________________________ Qualification : _________________________

Govt. Service 

Pvt. Service 

Others (please specify) : __________________________

Name of the Company / Office : _______________________________________________________________________________________

Nature of Business / Job

: ____________________________ Designation : _____________________________________________

Department

: ____________________________ Contact No (office) : _________________________________________

Office / Business Address

: _______________________________________________________________________________________

_________________________________________________________________________________ Pin : _________________________________

E-Mail ID

: ________________________________________________ Mobile No : ___________________________

(b) Mothers Name

: ________________________________________________ Qualification : _________________________

Occupation

Business 

Govt. Service 

Pvt. Service 

Others (please specify) : __________________________

Name of the Company / Office : _______________________________________________________________________________________

Nature of Business / Job

: ____________________________ Designation : _____________________________________________

Department

: ____________________________ Contact No (office) : _________________________________________

Office / Business Address

: _______________________________________________________________________________________

_________________________________________________________________________________ Pin : _________________________________

E-Mail ID

: ________________________________________________ Mobile No : ___________________________

3

Enrolment Form

(c) Details of the Local Guardian reference (Mandatory if the student is joining as a hosteler)
Local Guardians Name
Occupation

: ________________________________________________ Qualification : ________________________

Business 

Govt. Service 

Pvt. Service 

Others (please specify) : __________________________

Name of the Company / Office : _______________________________________________________________________________________

Nature of Business / Job

: ____________________________ Designation : _____________________________________________

Department

: ____________________________ Contact No (office) : _________________________________________

Office / Business Address

: _______________________________________________________________________________________

_________________________________________________________________________________ Pin : _________________________________

E-Mail ID

: ________________________________________________ Mobile No : ___________________________

Mailing Address

: _______________________________________________________________________________________

________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
_________________________________________________________________________________ Pin: _________________________________

(d) Details of the Sibling(s)

(if applicable)

1. Name

: _______________________________________________________________________________________

Class studying in

: ___________________________ Enrolment No. (if enrolled with FIITJEE) :_________________________

2. Name

: _______________________________________________________________________________________

Class studying in

: ___________________________ Enrolment No. (if enrolled with FIITJEE) :_________________________

3. Name

: _______________________________________________________________________________________

: ___________________________ Enrolment No. (if enrolled with FIITJEE) :_________________________

Class studying in

Details of the examination(s) of the class last passed / currently studying

Name of the Examination(s)

Board

Year of passing / appeared

Fee Details :

Fee Plan opted ():

Fee Plan Code

II

Total
Aggregate
Marks (%)

PCM /
Science + Math
(%)

III

: _______________________________________

(please refer course fee Annexure)

Detail(s) of Demand Draft(s) / Pay Order(s)
S. No.

Instrument Number

Dated

Issuing Bank & Branch

Amount (in Rs.)

1
2
3
4
Total

Enrolment Form

Annexure A
TERMS & CONDITIONS FOR POST DATED CHEQUE(S)
I understand that if my son /daughter / ward withdraws from the Program to which he/she has been admitted
at any point of time or does not attend the Program and thus the seat given to him/her is rendered vacant, the
same will not/can not be filled up by any other candidate and a vacancy created in the batch due to withdrawal
of a student after the starting of classes or up to 2 days prior to the same cannot be filled in any case, therefore I
understand that FIITJEE shall suffer irreparable losses in case of non-payment of remaining fee of the installment
plan, hence it will be unethical not to honor the Post Dated Cheque(s). I have opted for installment fee plan and
have submitted the Post Dated Cheque(s) as per the details give below.

Affix one self attested

passport sized
photograph of the person
issuing Post Dated
Cheque(s) i.e. parents /
guardian

I agree that, I will make arrangement, for below stated Post Dated Cheque(s), to get honoured, and will keep
sufficient funds on or before the due date for the same.
Detail(s) of Post Dated Cheques (Only Local / Payable at par cheques will be accepted)
S. No.

Cheque No.

Dated

Issuing Bank

Fee Amount

S. Tax Amount

Total Amount

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

I further agree to get above Post Dated Cheque(s) cleared, even if, my son / daughter / ward discontinues studies at FIITJEE,
irrespective of any reasons.
I am signing the above declaration in good mental / physical health. I have satisfied myself about FIITJEE. The necessary
Enrolment-Forms, including this form was received by me several days before the actual date of signing to enable me to understand the
implications of taking admission at FIITJEE. I have taken expert opinion regarding matters which were not clear to me and I am satisfied.

Signature of the Student

Name : ____________________________________________________

Father / Mother / Legal Guardians Signature

{Who has issued the cheque(s)}

Enrolment Number (for office use only) : __________________________

Name : ______________________________________

Date : _____________________________________________________

Address : ____________________________________

I have retained photocopy of this document for my reference before submitting it at FIITJEE.
Date : _________________________________

Father / Mother / Legal Guardians Signature

Place : _________________________________

Name : ______________________________________

Enrolment Form

Annexure B
CONSEQUENCES OF DISHONOUR OF POST DATED CHEQUE(s)
I understand that non-clearance of any of the Post Dated Cheque(s), submitted for payment of fees (on installment basis) as mentioned
in the Enrolment-Form and annexure B is punishable under Sec. 138 (B) of the Negotiable Instrument Act. I understand that FIITJEE
shall be entitled to proceed and initiate appropriate legal action against me, to recover the amount of the Post Dated Cheque(s) along
with the legal expenses and out of pocket expenses incurred by FIITJEE.
In case any of my Post Dated Cheque(s) bounces for any reason whatsoever, I undertake to submit a DD/Pay-Order in favour of
FIITJEE Ltd. payable at New Delhi, within four days of the bouncing of the Cheque(s) at my bank, together with Rs. 500/- (Rupees
five hundred only) as default money alongwith late payment of Rs. 50/- (Rupees fifty only) per day upto 10 (Ten) days from the due
date of payment of instalment after which my son / daughter / ward shall be debarred from classes without any further notice and I shall
have no claim for refund of fees or any support in studies besides Legal action inter alia action under Section 138 (B) of the Negotiable
Instrument Act may be initiated against me/us.

Signature of the Student

Name : ____________________________________________________

Father / Mother / Legal Guardians Signature

{Who has issued the cheque(s)}

Enrolment Number (for office use only) : __________________________

Name : ______________________________________

Date : _____________________________________________________

Address : ____________________________________

_____________________________________________
_____________________________________________

I have retained photocopy of this document for my reference before submitting it at FIITJEE.

Date : _________________________________

Father / Mother / Legal Guardians Signature

Place : _________________________________

Name : ______________________________________

Enrolment Form

Annexure C
PARENT DATA SHEET
(CONFIDENTIAL)
Dear Parent / Guardian,
The right and accurate feed back of your ward/student will give us an opportunity to understand the student better which will help us
in providing better support & education. This information will be confidential.

1. Name of the Student

: ______________________________________________________________________________

2. Fathers/Guardians Name

: ______________________________________________________________________________

3. Relation with Student

: ______________________________________________________________________________

4. How would you rate the student in the following characteristics ? ( the appropriate)
Excellent

Good

Average

Below Average

Low

Unknown

Sincerity
Leadership
Imagination
Emotional stability
Ability to work with others
Ability to work hard
Perseverance

6. What is the students class rank? : ____________________________________________________________________________

7. Some gifted individuals make mediocre scholastic records. Is the students record an accurate index of his/her capabilities?

Yes / No

If no, state why?

: ______________________________________________________________________________

8. What is the students biggest weakness? : ______________________________________________________________________

9. Have there been any major changes in the students attitude towards studies till now at any time, if so illustrate, when and why?
(You may attach a blank page if required.)

10. Please mention any other information relating to the student, which help make FIITJEE understand the student better.

________________________________________________________________________________________________________

________________________________________________________________________________________________________
11. My son / daughter / ward has a sound moral character & sense of responsibility. He/she also has good physical and mental health
to successfully cope up & complete his/her studies at FIITJEE and fulfill all terms & conditions.

Father / Mother / Legal Guardians Signature

Date : _________________________________

Place : _________________________________

Enrolment Form

Annexure D
Kindly do not take admission at FIITJEE if the clauses of the declaration on the Enrolment Form on page no. 10 & 11
is not agreeable to you.
Name of the Student : _________________________________________________________________________________________
Name of the Father / Parent / Guardian: ___________________________________________________________________________
Residential address : ___________________________________________________________________________________________
Specific Declarations (10 & 22) are being reproduced hereunder :
Declaration 10 :
In addition to the above, I understand without any ambiguity, that the fee once paid is not refundable at all, whatever the reasons be,
neither is it adjustable towards any other existing courses at FIITJEE or any yet to be launched nor towards the fee of any other existing
or prospective student.
Declaration 22 :
I/We, the parent / guardian and/or the student, hereby severally and jointly declare unambiguously that I/We have read and understood
all the clauses contained in this Enrolment form, Annexure and Declarations and agree to abide by them without any reservation or
ambiguity.
I/We further declare that the above named student is taking admission in the ____________________________________________
___________________________________________________(course opted for) having considered everything material and on his/her
own sweet will and with the permission of the Father / Mother / Legal Guardian without any coercion from any side.

Signature of the Student

Name : ____________________________________________________

Father / Mother / Legal Guardians Signature

Name : ________________________________________

Enrolment Number (for office use only) : __________________________

Address : _______________________________________

Date : _____________________________________________________

________________________________________________

I have retained photocopy of this document for my reference before submitting it at FIITJEE.

Date : _______________________________ Place : _____________________________

Father / Mother / Legal Guardians Signature

Instruction : After filling-up annexure A, B, C & D please retain photocopy of the same before submitting at the FIITJEE

Checklist :

1. Demand Draft(s) / Pay Order(s) for the fee

2. Local / at par post dated cheque(s)

3. Enrolment Form duly filled in

4. Annexure A to D

5. Colour Photographs:

(a) Passport size (Six)

(b) Stamp size 2.5 x 2 cm. (One)

6. Admission Test / FTRE / FTSE / Fortunate - 40 Hall Ticket (in Original)

7. Admission offer letter (in Original)

8. Any one of the following documents :

(a) Photocopy of School ID card with photograph or

(b) Photocopy of last Board or School Marksheet supported by any Identity Proof of student or

(c) Photocopy of Transfer Certificate or

(d) Bonafide certificate issued by the Principal of School with students photograph

Enrolment Form

Important Information for Students (and their parents / legal guardians)

1.

Before Taking Admission - Each Candidate, His/Her Parents & Legal Guardians are required to (a) Go through the FIITJEE Leaflet / Brochure / Information Booklet, word of advice, selection letter & website thoroughly. Other than these
no other verbal assurance of any kind is given by FIITJEE.
(b) It is advised that student undergoes a comprehensive Medical Examination to ensure that he/she is physically & mentally fit to take the
rigors of preparing for a competitive exam including but not limited to JEE Advanced & JEE Main etc. as the case may be.
(c) Meet few FIITJEE students successful in IIT-JEE / AIEEE {now JEE Advanced & JEE Main respectively}, NTSE etc & learn what made
them successful. What was the contribution of FIITJEE in their success? Also meet a few FIITJEE students not successful in IIT-JEE /
AIEEE {now JEE Advanced & JEE Main respectively} / NTSE & learn why they could not qualify IIT-JEE / AIEEE {now JEE Advanced &
JEE Main respectively} / NTSE.

We highly advise that you also talk to Non - FIITJEE students both successful in IIT & the unsuccessful ones, to form a clear opinion regarding
what a coaching institute can do for you.

Please do not take admission at FIITJEE if you think FIITJEE is not the best for JEE coaching.

An intelligent student having aptitude & analytical skills for JEE / NTSE etc has to have self study for at least 3 hrs. for every hour taught at
FIITJEE. Needless to say if you have not been a highly analytical student you have to put in even greater efforts.

For success in JEE, it is also important to have excellent performance In XII Board Exams. Furthermore, JEE is a different exam where you
will feel lost if you do not focus on fundamentals and/or you do not develop / have high analytical skills. Any amount of effort will be in vain
without high analytical skills. Admission at FIITJEE does not mean that you have high analytical skills. FIITJEE teachers will guide you in such a
way that your fundamentals are strengthened and you can improve your analytical skills tremendously, whether it happens or not will depend
upon you. The only way to develop strong fundamentals & improve your analytical skills & therefore your chances to get through JEE Main /
JEE Advanced / NTSE, etc with excellent School / Board performance is to solve each & every problem in FIITJEE assignments yourself. You
may have to make several attempts & even go back to your basics to refresh them to solve a particular problem. It is this intensity & quality
of effort which will help you develop good analytical skills. Ultimately a student who is enrolled with institute will have to continuously work
hard and must be regular in studies. In case, the teachers feel that the student is not working hard, is creating indiscipline in the Institute,
is irregular in attendance or is not responding properly, he/ she may be expelled from the institute. The decision of FIITJEE in this regard
will/shall be final and binding on the students. No fee or part of the fee will be refunded in such case.

In the end remember, while anyone can appear in JEE Main / JEE Advanced or pretend to prepare but only the ones who walk the right path will
succeed. FIITJEE has no magic potion to make you successful. Preparing to achieve optimum performance in both Boards & JEE will challenge
every bit of your mental & physical energies.

2. FIITJEE starts making arrangements of infrastructure, faculty & other resources about 6 months before commencement of financial year.
FIITJEE admits students as per its capacity plans, (subject to unforeseen circumstances & usual organizational risks) therefore each student
taking admission has to pay complete fee under all circumstances i.e. even if he/she discontinues for any reason whatsoever or parents /
guardians be transferred. Not all students who sit in our admission test are offered admission therefore you & parents have to be very sure
before taking admission as you have to pay complete fee under all circumstances.

Once a class starts FIITJEE does not admit any students. Therefore, any vacancy created by a student leaving cannot be filled up. Since FIITJEE
has to source infrastructure, faculty etc. in advance, loss of fees of students leaving after taking admission will compel the institute to enhance
fees for next batch of students which is unfair to them. Therefore, students / parents must clearly understand this important aspect and take
admission only if they are fully satisfied.

3.

Any change in government rules, regulations, policies pertaining to the courses of competitive exam such as JEE Main / JEE Advanced,
Olympiads, KVPY, NTSE etc. which may render these exams as deleted or cancelled. In such eventuality, FIITJEE shall not be held responsible
in any manner whatsoever. However, FIITJEE shall take all necessary steps to protect the interest of students.

Students Signature

Signature of Father / Mother / Legal Guardian

Name : _________________________________

Name : _________________________________

Date : __________________________________

Date : __________________________________

Place : __________________________________

Place : __________________________________

Enrolment Form

DECLARATIONS / UNDERTAKINGS
Kindly do not take admission at FIITJEE, if the following declarations are not agreeable to you

Please read the Declarations / Undertakings carefully before signing

Declaration:
1.

I/We hereby declare that the information furnished on this enrolment form etc. is correct to the best of my knowledge and belief.

2.

I am taking admission in FIITJEE with the consent of my Father / Mother / Legal Guardian and after being satisfied in all respects.

3.

I/We undertake that the information / details furnished / given by me/us are correct and if any discrepancy is found in the said details / information,
at any stage of my association with FIITJEE, FIITJEE may take any legal action against me/us which FIITJEE may deem fit including but not limited
to my (student) expulsion from the institute and I/We shall not be entitled for any refund of fees / claim / compensation / damages etc.

4.

I/We undertake that I/We shall furnish / submit / complete the remaining required documents and formalities by at least two days prior to
commencement of course program. However if I fail to do so, FIITJEE may not allow me to attend the classes, unless otherwise allowed by
FIITJEE in writing. I/We further undertake that I/We shall not claim any refund of fees/ cost of study material etc. already paid on ground of
inability to furnish/complete documents / formalities.

5.

I/We understand and acknowledge that FIITJEE does not give any guarantee / promise / assurance for success in JEE Main / JEE Advanced /
XII boards, inspite of providing the best teaching faculty and methodology, due to high-end competition and limited number of seats in IIT.
I undertake that I shall not hold FIITJEE responsible if I may not succeed the JEE or other competitive exam.

6.

I/We understand and acknowledge that preparation for JEE requires exhaustive hard work, extensive study, motivation and self confidence.
I undertake that I shall follow the rules and teaching methodology beside study and practice rigorously without loosing self-confidence.

7.

I/We clearly understand that FIITJEE on completion of topics to be covered by FIITJEE in Class XI as per its plan, will do goal refocusing for all
Two Year Classroom Program students including PINNACLE program students to help each student achieve maximum possible success. This
means that some students based on their performance, may have to predominantly focus on exams other than JEE (Main & Advanced).

8.

I undertake that if I leave the institute midway before completing the full course for any reason whatsoever, including but not limited to transfer
of my Father / Mother / Legal Guardian / ill health of myself or any other member of the family or my admission in any institute / course /
engineering college etc., or my studentship is cancelled because of misconduct etc., I or my Father / Mother / Legal Guardian shall not be entitled
for refund of fees.

9.

I/We undertake that once I (student) join the study centre / program offered by FIITJEE, I/We shall not be entitled to change the study centre /
program nor will I be entitled to refund of fees. However, if FIITJEE finds me competent / eligible for the higher course / program, it may consider
my request for change of program subject to payment of difference of course / program fee.

10. In addition to the above, I understand without any ambiguity that the fee once paid is not refundable at all, whatever the reasons be, nor is it adjustable
towards any other existing courses at FIITJEE or any yet to be launched nor towards the fee of any other existing or prospective student.
11. I undertake that I shall abide by the rules & regulations of FIITJEE or FIITJEEs associated schools. I undertake that in case of any dispute relating
to breach / violation of any of the Rules & Regulations of FIITJEE or FIITJEEs associated school, the decision of the Management of FIITJEE shall
be final and binding in all circumstances and situations, whatsoever.
12. It is understood that this admission is valid only for the course and the duration for which I am taking admission and I/We (the student and the
Parents / Legal Guardian) shall not claim / request for admission to and adjusting the fees to any other course or duration.
13. I/We acknowledge that the course materials provided to the student by FIITJEE during the course of study at FIITJEE are the intellectual property
of FIITJEE and solely for personal purposes and not for commercial use. I further undertake that I shall not make copies of the study material
provided by FIITJEE nor shall provide / give / distribute it to anyone else.
14. FIITJEE has enjoyed great relationship with the students and parents. Almost all students in every class and every program have been succeeding
in coping up with huge pressure of simultaneous preparation for competitive exams along with school / board studies. In few cases where some
students do discontinue because they are not able to cope up with simultaneous competitive exam preparations along with school / board
studies, the parents have continued to support the good work of FIITJEE.

What will constitute deficiency in service?

If the average feedback of the particular subject teacher goes below 70% in the Feedback Form Annexure - FB (attached herewith), then
the said teacher will be considered to teach below the minimum FIITJEE Standard. If a teacher gets less than 70% feedback in two consecutive
periods then his/her teaching will be considered unsatisfactory by high FIITJEE standards.

15. I/We have fully satisfied ourselves with regards to quality and excellence of teaching at FIITJEE from all available information / sources and have
decided to study only at FIITJEE. I/We wish to pay the entire fees as per the Fee Plan ____________ (Fee Plan I / Fee Plan II / Fee Plan III) option
(the same is signed by me & the student and is attached with this enrolment form) at our own sweet will and convenience without any pressure
/ coercion from any one.
16. I/We agree to submit a photocopy of the JEE Admit Card of the student by 25th March of the concerned JEE year to FIITJEE and admit card of
various Other Engineering Entrance Exam as soon as I/We receive the same from the examining body.

Students Signature

Signature of Father / Mother / Legal Guardian

Name : _________________________________

Name : _________________________________

Date : __________________________________

Date : __________________________________

Place : __________________________________

Place : __________________________________

10

Enrolment Form

DECLARATIONS / UNDERTAKINGS
17. I/We fully understand that FIITJEE is giving the scholarship because the student is expected to bring laurels to FIITJEE and will spread good word
of mouth among the students. I/We undertake that I / we shall / will fully cooperate to achieve this objective including giving the JEE Admit
Card before 25th March of the concerned JEE year and signing the letter of appreciation lauding FIITJEE efforts. I/We further undertake that
I/We shall attend the seminars / workshops / felicitation / interview etc. conducted by FIITJEE after achieving rank by the student; however
FIITJEE shall alone bear the entire cost and expenses in respect thereof. I further undertake to endorse the efforts and contributions made by
FIITJEE In achieving the rank while giving Interviews to the media (print / electronic / web). If we fail to give the JEE admit card by 25th March of
the concerned JEE year, FIITJEE will have the right to discontinue the scholarship and/or recover the scholarship with interest and the student /
parents / legal guardian will have no objection to the same.
18. I/We (student and the parents) declare that FIITJEE will have sole claim over the outstanding academic performance of the student and further
agree to give a letter of appreciation to FIITJEE for the outstanding result in form of a Letter, a Video Interview or any other forum / format that
FIITJEE deems fit.
19. I/We undertake and acknowledge that incase I/We indulge in any kind of litigation with FIITJEE, I/We shall not be entitled for any Awards /
Rewards / Scholarships / Benefits etc. from FIITJEE and shall refund / return such Awards / Rewards / Scholarships / Benefits etc. If availed by the
student, within a period of 15 days, failing which FIITJEE shall be entitled to recover the same through the appropriate court / forum alongwith
interest, damages and cost of litigation.
20. I/We undertake that I (student) shall not indulge in any illegal / unethical / unprincipled / immoral / corrupt / dishonest activities which may
cause loss of property, reputation and goodwill of FIITJEE. I/We further undertake that I/We shall compensate for/ indemnify against any
loss /damage caused to FIITJEE.
21. If a student is awarded scholarship by FIITJEE and does not perform at a similar level after joining FIITJEE Classroom / Integrated School Program
then a probe may be lodged to find out if the student got scholarship on his / her own merit or by using any unfair means. Parents and Guardians of
the student will be liable to pay back full fee of the program (that the student is enrolled for) with interest plus expenses towards investigation and
also a compensation of Rs. 10 Lacs, if the investigating committee concludes that student had not secured the scholarship on his / her own merits.

Therefore, if your child has got scholarship using unethical means please do not take admission at FIITJEE.

22. I/We, the parent / guardian and/or the student, hereby severally and jointly declare unambiguously that I/We have read and understood all the
clauses contained in this Enrolment form, Annexure and Declarations and agree to abide by them without any reservation or ambiguity.
23. I/We further declare that the student named on page no. 3 is taking admission in the program as mentioned on page 3 having considered
everything material, on his/her own sweet will after giving due consideration to rigors of time, distance and studies ahead and with the permission
of the Father / Mother / Legal Guardian without any coercion from any side. Further I/We understand that the student is required to work hard
to attain the average standard of the batch allotted in order to cope up with studies and put in extra efforts if lagging behind in any subject / topic.
24. I/We further undertake to ensure that cheques / drafts including post dated cheques if any given by us will be honoured by our bankers. In the
event of these cheques/drafts being dishonoured, FIITJEE is at liberty to initiate any action against us including legal proceedings under section
138 of Negotiable Instruments Act or other appropriate law.
25. I know that registered office of FIITJEE Ltd. is situated at New Delhi.
26. I promise to abide by all rules and regulations of FIITJEE declaration, in letter and spirit.
27. In the event of any dispute between the parties regarding the interpretation of clauses of enrolment form or any claim etc. arising out of
taking admission in FIITJEE, the matter shall be referred to the Sole Arbitrator appointed by FIITJEE Ltd. The arbitration proceedings shall
be conducted in accordance with the provisions of the Arbitration & Conciliation Act, 1996 and statutory modification thereof & rules made
thereunder. It is further agreed that in spite of the fact that the Sole Arbitrator may be known to any of the Directors or share holders and
that he may have been dealing with the Company or had occasion to deal with any matter of this agreement shall not disqualify him. Even if
the Arbitrator may have expressed opinion in similar matter earlier shall also not render him disqualified. The arbitrator so appointed shall
not be incapacitated for reasons of their being the employee or an associate of FIITJEE Ltd. or Group / Subsidiary Companies, and for reasons
of having any prior linkage with the company. The decision of the arbitrator shall be final & binding on both parties. The venue of Arbitration
shall be Delhi / New Delhi only.
28. Subject to clause 27 above, I/We (the student and the Father / Mother / Legal Guardian) understand that in case of any legal dispute, the
jurisdiction will be an appropriate court/forum in Delhi / New Delhi only and I/We shall not take recourse to such an action in any other court /
forum or anywhere else. In case I do, I shall inform the relevant court / forum regarding this jurisdiction constraint.
29. I have read the above carefully and have understood it clearly. I/We have also read the current FIITJEE Brochure carefully and have understood
it clearly. I have kept a photocopy of all the pages of this enrolment form including this declaration and Annexures A, B, C & D for my
future reference and timely compliance.

Additional declaration for Integrated School Program Students only :

30. I / We (Student and the parent) am/are joining FIITJEEs Integrated School Program only after satisfying myself / ourselves about the structure
of program. Ill fully abide by the rules and regulations of the school. I also understand that in the event I am expelled from the school on any
disciplinary ground Ill raise no claim from FIITJEE for any academic and/or financial loss including course fee..

Students Signature

Signature of Father / Mother / Legal Guardian

Name : _________________________________

Name : _________________________________

Date : __________________________________

Date : __________________________________

Place : __________________________________

Place : __________________________________

11

Enrolment Form

DECLARATIONS / UNDERTAKINGS

(Declaration to be given by the student if Father / Mother / Legal Guardian does not reside in the Study Centre City, neither does he/she
have any Local Guardian)

As my Father / Mother / Legal Guardian do(es) not reside at _______________________________________ and I have no Local
Guardian. I own all responsibility on their / his / her behalf.

Date : _________________________________

Students Signature : ________________________________

Place : _________________________________

Name : _______________________________________________
(To be struck off, if Not Applicable)

(Declaration to be given if the Enrolment form is not signed by the Father / Mother / Legal Guardian at the time of admission)

I have received an extra copy of this Enrolment Form, which I shall send to my Father / Mother / Legal Guardian and submit to
FIITJEE within 15 days with his/her signatures. If I fail to do so unless a further relaxation has been given by the FIITJEE authorities
in writing, my admission shall be liable to be cancelled and I or my Father / Mother / Legal Guardian shall have no claim for refund
of fees or any other compensation of any type.

Date : _________________________________

Students Signature : ________________________________

Place : _________________________________

Name : _______________________________________________
(To be struck off, if Not Applicable)

For Office use only

Check list for the Accountant / Admission Coordinator.
v

Name of the Accountant / Admission Coordinator : _____________________________________________________________

The Application form is complete in all respect with Annexure A, B, C and D duly signed by the student and the parent.

The details of the scholarship offered.

o Cash scholarship (If any) : _______________________________________________________________________________

o Fee Waivers offered (If any) : ___________ % on ____________________________________________________ ground

o Hostel fee waiver (If any) : ______________________________________________________________________________

The certificates pertaining to scholarship are attached.

6 passport size and one stamp size photograph are attached.

Late payment charges / Admin. charges duly calculated and collected.

The fee charged has been duly matched and verified with the fee brochure.

Signatures on PDCs and on Annexure B and C are same.

Is the student joining as a Hosteler? If yes details of the Local Guardian are provided.

The student has been offered the admission after selection in Admission test only.

Declaration by the Accoutant / Admission Coordinator.

I have verified the entire Enrolment form and checked all the points mentioned above. The Enrolment is recommended.

Date : _______________________ Place : _________________________

12

Signature of the Account / Admission Coordinator

Enrolment Form

Classroom / Integrated School Programs

Program
Code

Program Name
For Admission in Class 6th
Little Genie - One Year Foundation Program - Regular Week Contact Classes

6051

LITTLE GENIE - One Year Foundation Program - Weekend Contact Classes

6052

Little Genie - One Year Foundation Program - Sunday Contact Classes

6053

Please affix the

2nd passport size colour
photograph of the
student here

For Admission in Class 7th

UDAYA Plus - Two Year Integrated School Program

7010

UDAYA - Two Year Classroom Program - Regular Week Contact Classes

7051

UDAYA - Two Year Classroom Program - Weekend Contact Classes

7052

UDAYA - Two Year Classroom Program - Sunday Contact Classes

7053

Please affix the

3rd passport size colour
photograph of the
student here

For Admission in Class 8th

UDAYA - One Year Classroom Program - Regular Week Contact Classes

8051

UDAYA - One Year Classroom Program - Weekend Contact Classes

8052

UDAYA - One Year Classroom Program - Sunday Contact Classes

8053

For Admission in Class 9th

Supreme - Four Year Integrated School Program for JEE Advanced

9020

ATHENA - Four Year Integrated School Program for JEE Main

9022

Four Year Classroom Program for JEE Advanced - Regular Week Contact Classes

9061

Four Year Classroom Program for JEE Advanced - Weekend Contact Classes

9062

Four Year Classroom Program for JEE Advanced - Sunday Contact Classes

9063

Four Year Classroom Program for JEE Advanced - Regular Week Contact Classes (Admission only for Class IX and X)

9064

Four Year Classroom Program for JEE Advanced - Weekend Contact Classes (Admission only for Class IX and X)

9065

Four Year Classroom Program for JEE Advanced - Sunday Contact Classes (Admission only for Class IX and X)

9066

Four Year Classroom Program for JEE Main - Regular Week Contact Classes

9071

Four Year Classroom Program for JEE Main - Weekend Contact Classes

9072

Four Year Classroom Program for JEE Main - Sunday Contact Classes

9073

For Admission in Class 10th

Three Year Classroom Program for IIT-JEE - Regular Week Contact Classes

1061

Three Year Classroom Program for IIT-JEE - Weekend Contact Classes

1062

Three Year Classroom Program for IIT-JEE - Sunday Contact Classes

1063

Three Year Classroom Program for JEE Advanced - Regular Contact Classes (Admission only for Class X)

1064

Three Year Classroom Program for JEE Advanced - Weekend Contact Classes (Admission only for Class X)

1065

Three Year Classroom Program for JEE Advanced - Sunday Contact Classes (Admission only for Class X)

1066

13

Please affix
the stamp
size colour
photograph of
the student here

Please submit
3 additional passport
size colour photographs
with this
Enrolment Form

Enrolment Form

Classroom / Integrated School Programs

Program
Code

Program Name
For Admission in Class 11th
Pinnacle - Two Year Integrated School Program for IIT-JEE

1110

PINNACLE - Two Year Integrated Program for IIT-JEE (Jr. College)

1112

Two Year Classroom Program for JEE Advanced - Regular Week Contact Classes

1151

Two Year Classroom Program for JEE Advanced - Weekend Contact Classes

1152

Two Year Classroom Program for JEE Advanced - Sunday Contact Classes

1153

Two Year Classroom Program for JEE Advanced - Special Weekend Contact Classes

1154

Two Year Classroom Program for JEE Advanced - Regular Week + Sunday Contact Classes

1155

Two Year Classroom Program for JEE Main - Regular Week Contact Classes

1171

Two Year Classroom Program for JEE Main - Weekend Contact Classes

1172

Two Year Classroom Program for JEE Main - Sunday Contact Classes

1173

Two Year Classroom Program for JEE Main - Special Weekend Contact Classes

1174

Two Year Condensed Classroom Program for IIT-JEE -Regular Week Contact Classes

1161

Two Year Condensed Classroom Program for IIT-JEE -Weekend Contact Classes

1162

Two Year Condensed Classroom Program for IIT-JEE - Sunday Contact Classes

1163

For Admission in Class 12th

One Year Classroom Program for JEE Advanced - Regular Week Contact Classes

1251

One Year Classroom Program for JEE Advanced - Weekend Contact Classes

1252

One Year Classroom Program for JEE Advanced - Sunday Contact Classes

1253

One Year Classroom Program for JEE Advanced - Regular Week + Sunday Contact Classes

1254

One Year Classroom Program for JEE Main - Regular Week Contact Classes

1271

One Year Classroom Program for JEE Main - Weekend Contact Classes

1272

One Year Classroom Program for JEE Main - Sunday Contact Classes

1273

One Year Classroom Program for JEE Main - Regular Week + Sunday Contact Classes

1278

Special One Year Weekend Classroom Program

1261

Special Weekend Classroom Program for IIT-JEE

1262

Intensive Contact Program for JEE Advanced

1264

Special One Year Classroom Program for JEE Main & Advanced

1266

Intensive Contact Program for IIT-JEE

1281

Super Rank Enhancement Classroom Program for IIT-JEE

1282

Crash Course for JEE Main

1286

For Admission After Class 12th

One Year Extended Classroom Program for JEE Advanced - Regular Week Contact Classes

1351

One Year Classroom Program for JEE Main - Regular Week Contact Classes

1371

One Year Classroom Program for JEE Advanced - Regular Week Contact Classes

1361

Special Classroom Program (for Ex-FIITJEEians)

1362

Intensive Contact Program for IIT-JEE

1381

Super Rank Enhancement Classroom Program for IIT-JEE

1382

Crash Course for JEE Main

1386

14

FIITJEE School Network

Delhi (South)
* This map is not to scale

Delhi (Punjabi Bagh)

Delhi (East)
Delhi (Dwarka)

Noida (Delhi-NCR)
Gurgaon (Delhi-NCR)
Faridabad (Delhi NCR)

Chandigarh

Ghaziabad (Delhi-NCR)
Lucknow

Jaipur

Kanpur
Allahabad

Gorakhpur

Gwalior
Bhopal

Varanasi

Vadodara

Patna

Indore
Kolkata

Nagpur
Mumbai (Kandivali)
Mumbai (Chembur)
Mumbai (Navi Mumbai)
Mumbai (Thane)
Mumbai (Bhandup)
Mumbai (Malad)

FIITJEE Junior College

Bhubaneswar
Bokaro

Pune

Ranchi

Bhilai
Raipur
FIITJEE Junior College
Visakhapatnam

Bangalore
PU College

FIITJEE Junior College

Vijayawada

Lakshadweep
(India)

Kochi
Coimbatore

Chennai (Adyar)
Chennai (Kilpauk)
Chennai (Sriperumbudur)
Chennai (KK Nagar)
Chennai (Anna Nagar)
Chennai (Thirumazhisai)

FIITJEE Associate Schools

FIITJEE Junior Colleges
FIITJEE PU College

Andaman and Nicobar

FIITJEE Junior Colleges

Hyderabad (Saifabad)
Hyderabad (Dilsukhnagar)
Hyderabad (Kukatpally)

FIITJEE Centre Network

Chandigarh

Delhi (South)

Delhi (Rohini)

Delhi (Punjabi Bagh)

Delhi (Janakpuri)

Delhi (East)

Delhi (Dwarka)
Noida (Delhi-NCR)
Gurgaon (Delhi-NCR)

Meerut
Amritsar

Faridabad (Delhi-NCR)
Ghaziabad (Delhi-NCR)

Lucknow (Gomti Nagar)

Lucknow (Aashiana)
Lucknow (Aliganj)

Jaipur (J.L.N. Marg)

Jaipur (Vaishali)
Jaipur (Vidyadhar Nagar)

Gwalior
Indore

Gorakhpur

Kanpur
Allahabad

Varanasi

Bhopal

Patna
Dhanbad
Bokaro

Vadodara
Nagpur

Kolkata (Rabindra Sadan)

Kolkata (Ultadanga-Salt Lake)

Mumbai (Chembur)
Mumbai (Kandivali)
Mumbai (Andheri)
Mumbai (Navi Mumbai)
Mumbai (Thane)

Durgapur

Wardha
Ranchi (Lalpur)
Ranchi (SOP Doranda)

Bhubaneswar
Cuttack

Raipur

Pune

Bhilai

Hyderabad (Saifabad)
Hyderabad (Dilsukhnagar)
Hyderabad (Kukatpally)

Shaktinagar NTPC

Chennai (Nungambakkam)
Chennai (Kilpauk)
Chennai (Adyar)
Chennai (Sriperumbudur)
Chennai (KK Nagar)
Chennai (Anna Nagar)
Chennai (Thirumazhisai)

Bangalore (HSR Layout)

Kochi
Lakshadweep
(India)

Coimbatore

Forum

for

Enrolment Form w.e.f. July, 2016

Vijayawada

Bangalore (Seshadripuram)

Andaman and Nicobar

Visakhapatnam

I I T- J E E

National Admissions Office : FIITJEE House, 29-A, Kalu Sarai, Near Hauz Khas Metro Station, Sarvapriya Vihar, New Delhi - 110 016
Ph. : 011 - 49283471 / 73 / 75 All India Toll Free No. : 1800 11 4242 Email : info@fiitjee.com Web : www.fiitjee.com

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