I I T - J E E A I E E E P M T

Registration No.: ............................................

Affix your
Enrollment No.: .............................................. recent passport
(To be filled by office only) size photographs
here
To,
THE ADMISSION INCHARGE
ENROLLMENT FORM
FOUNTAIN INTERNATIONAL COACHING INSTITUTE
7/C, Taimoor Nagar, Near Gurdwara,
BATCH OPTION
New Friends Colony, New Delhi 110065
Regular Classroom
COURSE APPLIED FOR Weekend

COURSE CODE

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

Father’s/Guardian’s Name Mother’s Name

Father’s Occupation Designation

Date of Birth Gender M F Category Blood Group

(Please Tick  the relevant box) (GEN / SC / ST / OBC / PH)

Residential Address

City State Pincode

Phone Fax
(STD Code) (Number) (Any Other) (STD Code) (Number)

Mobile E-mail
(Student’s)

Correspondence Address
(Please ignore if same as Residence Address)

City State Pincode

Phone Fax
(STD Code) (Number) (Any Other) (STD Code) (Number)

School / College Name & Address

Marks Obtained % (X Board - Sc. & Maths Aggregate) % (XII Board, PCM - Aggregate) Photocopy of the Marksheet to be attached

Board CBSE ISC UP/UT Any Other

Student Class category XI appearing XII appearing XII passed

Eligibility for Concession 5% 10% 20% 30% 40% 50% 100%

How did you come to know about Fountain? Mktg. Team Newspaper Teacher Friends Radio Website

Date: Place:
(Signature of Student)
 (FOR OFFICE USE ONLY)
Enrollment No.: ......................................... Registration No.: .................................. Course Offered: ........................ Batch No.: .................
Scholarship Offered: .................................. Net Fee: ................................... Receipt No.: ............................... Receipt Date: ......................
PAYMENT DETAILS
Sr. No. Date Receipt No. DD/Cheque No.
TERMS & CONDITIONS
1. When a student seeks admission to the institute, it is assumed by
the institute that he/she has an earnest purposes. He/she is
expected to aim at the highest achievement in every sphere and to
conduct him/herself in responsible and dignified manner
wherever he/she may be.
2. Incomplete form will be rejected, It is compulsory to attach an
attested photocopy of mark sheet of previous class and one
recent passport size photographs to the admission form. The
student should also staple three recent passport size photographs
along with the form.
3. It is compulsory/mandatory to provide e-mail ID / Mobile No. of the
student / father / guardian. The result of tests or any other
information by the Institute will be sent to the student on e-mail
ID/SMS/Call (any one) ,If he/she has not given his/her e-mail ID
/mobile no. in the Admission Test form at the time of admission
Institute shall not be responsible for correspondence.
4. Any change of address should be notified in writing to the office
within 7-10 days.
5. In case, if the teachers feel that the student is not working hard,
indiscipline , disturbing, irregular in attendance, not responding
properly then he/she may be expelled from the Institute. The
decision of the in charge in this regard will be final and binding on
the student. No fee or part of the fee will be refunded in such
cases.
6. If a student is absent without prior information for more than 15
days, he/she may be deemed to be expelled. The decision of the
Managing Director will be final in this regard.
7. The institution has absolute right to expel a student, if he/she is
found adopting unfair practices during the screening test. In that
case, screening test fee wouldn't be return.
8. Any study material given during the classes or otherwise, shall not
be given to those students who are absent without prior
application from the parents. No request / personal appointments
in this regard shall be entertained.
9. If the study material or any accessories provided to the student is
lost/misplaced, a new one can be obtained from the institute
against the payment of price determined b the institute.
10. Students are not allowed to carry mobile phone / I-pod in the class
rooms.However, if he/she carries mobile phone in the classes,
then it should be switched off. The Institute is not responsible for
any loss / theft of mobile phone or valuables or cash in the
Institute.
11. Each student will be issued an identity card. The entry in to the
class rooms/Institute will be only with Identity Card, If the Identity
card of a student is lost/misplaced, a duplicate I-card can be asked
from the Institute against payment of Rs. 50/-. If any student is
found misusing the I-card, he/she will be rusticated from the
Institute
12. The parents can enquire about the progress or any other
problems concerning their wards from the institute. They can also
meet the in charge with the prior appointment. Time to time the
institute will also send the progress report to parents.
13. Any negotiation about payment of fee or installment must be
cleared and written at the time of admission, if the installment is
not paid within stipulated time a further grace period of only 10
days will be given, after admission will considered automatically
cancelled and no claim will be entertained.
Bank - Name & Branch Amount (Rs.)
14. The fee once deposited towards a particular course is non
refundable to what so ever reason may be.
15. If at any point of time, the Central Govt. further increases service
tax, (existing rate of service tax is 10.33%) the extra amount of
service tax will be borne by the students from the date of
enforcement of the act by the Govt
16. Scholarships shall be given on the basis of merit test. Any decision
concerned with the matter will be at sole discretion of Fountain
Institute.
17. Scholarship on two-year program is applicable against the 2nd year
fee (with the last installment)
18. In case if any parent/guardian misbehaves with any staff
member of the Institute, his/her ward can be rusticated from the
Institute and no claim of refund of such student will be
entertained. The decision of the in charge will be final and binding
on the student and parent/guardian.
19. The institute reserves the right to make any alteration in its
programs / venue / timing and days of classes / fee structure
without any prior notice to anybody. The decision of the in charge
will be final & binding on the students & the parents.
20. The institute reserves the right to publish the photograph of
toppers/rankers/successful students, running classes. The
institute will not be liable to any legal proceeding against such an
act.
21. The institute will not be responsible for eligibility, forwarding of an
application form or appearance of a student in any entrance test. If
a student joins any particular course & fail to appear in that very
exam for whatsoever reason, no claim against the institute will be
entertained.
22. The institute does not guarantee of success in any particular
entrance exam. Students would be accountable for their success.
We will be their guide
23. If any type of mishap occurs in the premises of the institute
because of situations beyond our control or any other natural
calamity of any type such as earthquake, floods, fire, electric short
circuit etc, the institute shall not be responsible in any manner
whatsoever.
24. Every dispute falls under the jurisdiction of New Delhi only.
25. By joining the institution the student is bound by all its rules and
regulations
(Sign of the Parent / Guardian) (Sign of the Student)