Admission Form




ENROLMENT FORM
FOR
Regular
Test Series
Foundation
CENTRE: Pimpri Pune
Crash Course
(AAITS)
STREAM : 11th ,12th & ( 8th ,9th,& 10th)
IIT JEE ( Mains & Advance)
NEET/AIIMS
MH CET
FOR OFFICE USE ONLY
Enrollment No.
Registration No.
Admission No.
Course
Affix
Date of Birth
D
D
M
M
Y
Y
Y
Y
Batch : Drona
Ekalavya
Passport size
Photograph
SCHOLARSHIP DETAILS:
Defence
Academic Scholarship
(%)
Teacher
SC/ST
PH
State/ District/School Topper
ward
Others
%
Total Scholarship (%) :
+
+
+
=
Security
FEE DETAILS:
Total fee(Payable):
Plan 1
Plan 2
Plan 3
Down Payment
ACST + DIRECT
DIRECT ADMISSION
10.(a) NSE OLYMPIAD (Stage-1/ Stage-2/
1. Selection Letter
Final Stage)
13. 10th Marksheet
2. Fee Criteria
(b) RMO (Stage-1/ Stage-2/ Final Stage)
14. 12th Marksheet (for Target Batch)
3. School ID-Card
(c) NSEJS OLYMPIAD (Stage -1 / Stage-
or
JEE (MAIN/ ADVANCED)
2/ Final Stage)
4. Asquare Admit Card
Rank Card/JEE (MAIN) Admit Card
(d) NTSE (Stage -1/Stage-2)
5.
10th Admit Card
only for (RB/RS/Test Series/Crash
(e) KVPY (Stage-1/ Stage-2)
Course/Open Test)
6. No. of Cheques
(f) School Rank :
15. NEET/AIIMS
7. Category Proof
(g) Other Scholarship
Rank Card/NEET Confirmation page
8. Other Achievements Proof
only for (MRB/ Test Series/Crash
11 Undertaking
9. No. of Photos
12. Centre transfer form
CHEQUE/ DD DETAILS:
S.No.
Bank Name
Branch
Cheque/DD No.
Date
Amount
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Date:
Counsellor’s Signature
I agree that, I will make arrangement, for above stated Post Dated Cheque(s) to get honoured and will keep sufficient funds on or
before the due date for the same. I further agree to get above Post Dated Cheque(s) cleared, even if, my son / daughter / ward
discontinues studies at ASQUARE CLASSES, irrespective of any reasons. I am signing this declaration in good mental / physical
health. I have satisfied myself about ASQUARE CLASSES.
Signature of Parent/Guardian
Signature of Student
PERSONAL DETAILS OF STUDENTS
Have you previously enrolled in Asquare Classes ?
Yes
No
(if Yes) Enrolment No
Name
Gender : Male
Female
Category : GEN
OBC(NCL)
SC/ST
PH
Phone (STD)
0
C
O
D
E
Mobile Number
Alternate Number
(DND Free)
(DND Free)
Email ID
Mother’s Name
Occupation
Designation
Father’s/Guardian’s Name
Occupation
Designation
Annual Income of Parent
(Lac per annum)
If Father/Mother/Teacher: School Name_________________________________Board____________________District______________
CORRESPONDENCE ADDRESS
City/Town
State
Pin
Country
PERMANENT ADDRESS
City/Town
State
Pin
Country
ACADEMIC DETAILS
10
11
12
12 PASS
Class Studying :
8
9
DETAILS OF SCHOOL STUDYING IN/LAST ATTENDED
School Name
School Address
City/Town
State
Pin
Phone:
C
O
D
E
School affiliated to :CBSE
ICSE
If others (Please specify)
MHSB
DETAILS OF LAST EXAMINATION PASSED ( as in Registration Form)
Grade/Percentage (%) secured
Overall CGPA/Aggregate
Year of Passing
Class
School/Board
Percentage (%)
Science
Maths
DECLARATION
I hereby declare that the information provided by me in this Enrolment Form is correct to the best of my knowledge.
Place:
Date:
Signature of Parent/Guardian
Signature of Student
RULES & REGULATIONS
This document informs you of the various Rules and Regulations of Asquare
parents.
Classroom Centre. Please read this carefully and sign at the end for
16. (a) The registered office of Asquare Classes is at Pune. All disputes and
acceptance.
differences of any nature with regard to Admission process, subsequent
1.
Admission to all programs is at the sole discretion of the management of
enrolment and studies shall be referred to the sole Arbitrator appointed by
Asquare classes.
the Management of Asquare Classes. The Arbitration proceedings shall
be conducted in accordance with the provisions of the Arbitration and
2.
Fee once paid will not be refunded or adjusted at any stage, under any
Conciliation Act 1996 and statutory modification thereof and rules made
circumstance.
there under. The award of the arbitrator shall be final & binding. The
3.
Students enrolled at Asquare classes Classroom Centre have to maintain
arbitrator so appointed shall not be incapacitated for reasons of their being
proper decorum in the institute premises at all times. Indiscipline of any
the employee of Asquare Classes or its sister concern, and for reasons of
form or misbehaviour with staff could lead to suspension/ rustication.
having any prior linkage with the company. The seat of arbitration will be
4.
Students, who frequently come late to the institute, may not be allowed in
Pune. All the parties – Student/Parents/guardian & Asquare classes
the institute premises.
agree that they shall not commence or maintain any action in court of law
5.
If a student is absent from classes for more than three days in a row,
relating to Admission process subsequent enrolment & studies at Asquare
classes Pvt. except for enforcement of the arbitral award. All parties
he/she is required to intimate the incharge of Help Session. In case of
absenteeism for long periods without prior intimation, the admission of
waive any right to appeal. This is needed for speedy redressal of issues &
student may be deemed cancelled without any notice and without any
all parties agree to this.
refund of fee.
(b) Subject to 16(a) herein above, the exclusive jurisdiction in the matter
shall vest in Pune Court only.
6.
Any change of address or phone number should be notified to the incharge
of Help Session without delay.
17. Change in Centre, Change in course and change in batch shall be at the
7.
Student must be in possession of Asquare Classes Identity card while
sole discretion of the management.
coming for classes and must produce the same for scrutiny by the Asquare
(a) Change in Centre: No such policy.
Classes staff, before entry. Identity card lost / misplaced will be replaced
with a duplicate Identity Card on depositing a passport size photograph
(b) Change in course:The student will have not to pay any thing,
and Rs. 100/-.
which he wants to above switch. The fee of the said course shall be
8.
Late Payment of fee shall attract late fine per day from immediately after
decided by the management. In addition to the above fee, the student will
the due date. Late fee upto Rs. 5000/- shall attract late fine of Rs. 10 per
have not to pay as administrative charges.
day, Late fee of Rs. 5001-10000 shall attract late fine of Rs. 15 per day,
(c) Change in batch: Batch change may be allowed on availability of
Late fee of Rs. 10001-15000 shall attract late fine of Rs. 20 per day & Late
seats. Batch change fee shall depend on the batch starting date.
fee above Rs. 15001 shall attract late fine of Rs. 25 per day. This may
We request the students/parents to help us maintain the decorum of the
change time to time without prior notice.
institute.
9.
If any cheque is dishonoured for any reason, appropriate action may be
Consequences of Dishonour of Post Dated Cheque(s)
initiated as per Negotiable instrument Act. An administrative charge of Rs.
500/- would be levied for every dishonoured cheque, in addition to the late
I understand that non-clearncance of any of the Post Dated Cheque(s),
payment fee mentioned in point no. 8 above. The fee in lieu of the
submitted for payment of fees (on installment basis) as mentioned in the
dishonoured cheque including charges will only have to be submitted vide
Enrolment-Form and annexure “B" in punishable under sec. 138(B) of the
a Bank Demand Draft/Pay Order/Cash.
Negotiable Instrument Act. I understand that ASQUARE CLASSES shall be
entitled to proceed and initiate appropriate legal action against me, to recover
10.
In case of any increase in the Service Tax or Education Cess (from the
the amount of the Post Dated Cheque(s) along with the legal expenses and out
existing rate of 15% Service tax) by the Government of India, such
of pocket expenses incurred by ASQUARE CLASSES.
increase in tax shall be borne by the student from the date of
notification by the Government of India.
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 ASQUARE CLASSES
11.
The student is responsible to see for himself/herself whether he/she is
payable at Pune, within four days of the bouncing of the Cheque(s) at my bank,
eligible for a certain examination / course or not. The institute would not be
together with Rs. 500/- (Rs. Five hundred only) as default money alongwith late
held responsible if the students admission form is not forwarded or is
rejected on any ground. Getting admission forms and submitting to the
payment of Rs. 50/- (Rs. 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
concerned examination body will be the sole responsibility of
from classes without any further notice and I shall have no claim for refund of
student/parents.
fees or any support in studies besides Legal action inter alia action under
12. Students enrolled with Asquare Classes have to submit a photocopy of
Section 138 (B) of the Negotiable Instrument Act may be initiated against me /
their admit card and application form of JEE (Main & Advanced) /NEET,
us.
AIIMS or any other Entrance Examination as soon as they receive it, failing
I have read all the above Rules & Regulations and understood them in their
which the services to students like classes, tests, study materials etc may
be stopped from Asquare Classes.
totality. I hereby declare that I accept and will adhere to them.
13. Asquare Classes reserves the right to use the photographs and /
testimonial letter of the student in any promotional / publicity material of the
Date:
institute.
14. In order to help the student, the institute may provide information about
Place:
some private hostels/transport provider being run in the vicinity of the
institute. Asquare classes does not take any responsibility for any such
hostel/transport provider whose information may be provided.
15. Asquare Classes reserves the right to change or alter the classroom
Signature of Student
Signature of Parent/Guardian
program, fee or rules and regulations without any prior notice to anybody.
The management decision shall be final and binding on the student and
CORPORATE OFFICE
BRANCH OFFICE : Building No.457/2545 2nd Floor
Sant Tukaram Nagar, Pimpri Pune, Maharastra – 411018
Mob No. : 9404282283 | CALL : 9766118866 / 77
Web. : www.asquareclasses.com, Email: asquareclasses@gmail.com
Unit of ASQUARE CLASSES PVT LTD. PUNE