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ENROLLMENT FORM
I I T - J E E A I E E E P M T
Affix your
recent passport
size photographs
here
Registration No.:
............................................
Enrollment No.:
..............................................(To be filled by
office only)
To,
THE ADMISSION INCHARGE
FOUNTAIN INTERNATIONAL COACHING INSTITUTE
7/C, Taimoor Nagar, Near Gurdwara,
New Friends Colony, New Delhi 110065
COURSE APPLIED FOR
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)
How did you come to know about Fountain?
First Name Last Name
School / College Name & Address
Father’s/Guardian’s Name Mother’s Name
Father’s Occupation Designation
Date of Birth Gender FM Category(Please Tick the
relevant box) (GEN / SC / ST / OBC / PH)
Blood Group
Residential Address
City State Pincode
Phone Fax(STD Code) (Number) (Any Other) (STD Code) (Number)
Mobile(Student’s)
E-mail
Correspondence Address
City State Pincode
Phone Fax(STD Code) (Number) (Any Other) (STD Code) (Number)
(Please ignore if same as Residence 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%
(Signature of Student)Date:
Mktg. Team Newspaper Teacher Friends
WebsiteRadio
Place:
100%
BATCH OPTION
Regular Classroom
Weekend
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Enrollment No.: .........................................
Registration No.: .................................. Course
Offered: ........................ Batch No.: .................
Scholarship Offered: .................................. Net Fee:
................................... Receipt No.:
............................... Receipt Date:
......................
(FOR OFFICE USE ONLY)
PAYMENT DETAILS
Sr. No. Date Receipt No. DD/Cheque No. Bank - Name & Branch
Amount (Rs.)
TERMS & CONDITIONS
1. When a student seeks admission to the institute, it is
assumed bythe institute that he/she has an earnest purposes. He/she
isexpected to aim at the highest achievement in every sphere and
toconduct him/herself in responsible and dignified mannerwherever
he/she may be.
2. Incomplete form will be rejected, It is compulsory to attach
anattested photocopy of mark sheet of previous class and onerecent
passport size photographs to the admission form. Thestudent should
also staple three recent passport size photographsalong with the
form.
3. It is compulsory/mandatory to provide e-mail ID / Mobile No.
of thestudent / father / guardian. The result of tests or any
otherinformation by the Institute will be sent to the student on
e-mailID/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
admissionInstitute shall not be responsible for correspondence.
4. Any change of address should be notified in writing to the
officewithin 7-10 days.
5. In case, if the teachers feel that the student is not working
hard,indiscipline , disturbing, irregular in attendance, not
respondingproperly then he/she may be expelled from the Institute.
The
decision of the in charge in this regard will be f inal and
binding onthe student. No fee or part of the fee will be refunded
in suchcases.
6. If a student is absent without prior information for more
than 15days, he/she may be deemed to be expelled. The decision of
theManaging Director will be final in this regard.
7. The institution has absolute right to expel a student, if
he/she isfound adopting unfair practices during the screening test.
In thatcase, screening test fee wouldn't be return.
8. Any study material given during the classes or
otherwise, shall notbe given to those students who are absent
without priorapplication from the parents. No request / personal
appointmentsin this regard shall be entertained.
9. If the study material or any accessories provided to the
student islost/misplaced, a new one can be obtained from the
instituteagainst the payment of price determined b the
institute.
10. Students are not allowed to carry mobile phone / I-pod in
the classrooms.However, if he/she carries mobile phone in the
classes,
then it should be switched off. The Institute is not responsible
forany loss / theft of mobile phone or valuables or cash in
theInstitute.
11. Each student will be issued an identity card. The entry in
to theclass rooms/Institute will be only with Identity Card, If the
Identitycard of a student is lost/misplaced, a duplicate I-card can
be askedfrom the Institute against payment of Rs. 50/-. If any
student isfound misusing the I-card, he/she will be rusticated from
theInstitute
12. The parents can enquire about the progress or any
otherproblems concerning their wards from the institute. They can
alsomeet the in charge with the prior appointment. Time to time
theinstitute will also send the progress report to parents.
13. Any negotiation about payment of fee or installment must
becleared and written at the time of admission, if the installment
isnot paid within stipulated time a further grace period of only
10days will be given, after admission will considered
automaticallycancelled and no claim will be entertained.
1 .refundable to what so ever reason may be.
15. If at any point of time, the Central Govt. further increases
servicetax, (existing rate of service tax is 10.33%) the extra
amount ofservice tax will be borne by the students from the date
ofenforcement of the act by the Govt
16. Scholarships shall be given on the basis of merit test. Any
decisionconcerned with the matter will be at sole discretion of
FountainInstitute.
nd17. Scholarship on two-year program is applicable
against the 2 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
theInstitute and no claim of refund of such student will
beentertained. The decision of the in charge will be final and
bindingon the student and parent/guardian.
19. The institute reserves the right to make any alteration in
itsprograms / venue / timing and days of classes / fee
structurewithout any prior notice to anybody. The decision of the
in chargewill 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.
Theinstitute will not be liable to any legal proceeding against
such anact.
21. The institute will not be responsible for eligibility,
forwarding of anapplication form or appearance of a student in any
entrance test. Ifa student joins any particular course & fail
to appear in that veryexam for whatsoever reason, no claim against
the institute will beentertained.
22. The institute does not guarantee of success in any
particularentrance 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
institutebecause of situations beyond our control or any other
naturalcalamity of any type such as earthquake, floods, fire,
electric shortcircuit etc, the institute shall not be responsible
in any mannerwhatsoever.
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
4 The fee once deposited towards a particular course is non
(Sign of the Parent / Guardian) (Sign of the Student)
