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Walk-In & Admission Form - Final

The document is a student enrollment form that collects personal details of the student such as name, date of birth, contact information, address, parents' names and occupations, siblings' academic details, the student's school and academic performance, how they heard about the program, the programs and courses they are interested in, and whether they want to take an admission test. It asks for details to register a student for educational programs and collects their academic history and preferences to recommend suitable options.

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vijar198485
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111 views1 page

Walk-In & Admission Form - Final

The document is a student enrollment form that collects personal details of the student such as name, date of birth, contact information, address, parents' names and occupations, siblings' academic details, the student's school and academic performance, how they heard about the program, the programs and courses they are interested in, and whether they want to take an admission test. It asks for details to register a student for educational programs and collects their academic history and preferences to recommend suitable options.

Uploaded by

vijar198485
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Form No:

An IIT Kharagpur Alumni Initiative


Student Name:

Personal Details

Date of Birth:
Contact No 1:

DD/MM/YYYY

Sex:

Student/Parent

Female

Male

Parent/Guardian

Contact No 2:

Residential/Correspondence Address:
City:

Pin Code:

Fathers Name:

Occupation:

Mothers Name:

Occupation:

Name & School/College of Sibling(s) (If applicable):

Academic Details

School:
Board: ICSE

School of the Student


ISC

Class In 2015-16 session

WBBSE

WBHS

CBSE

Aggregate Marks obtained in last exam (School/Boards) %

Others

Rank (if applicable) _________________

Exams Appeared in: Name:__________________________ Year_______ Marks/Rank ___________________

like NTSE,
Olympiads,
KVPY, NSEJS
Mode of Study:

Name:__________________________ Year_______ Marks/Rank ___________________


Name:__________________________ Year_______ Marks/Rank ___________________
Self Study

Coaching/Tutor

E-Learning

Correspondence (Choose 1 or more)

How did you come to know about Edudigm?


Newspaper Ad

School

Online/SMS

Others

Please specify

Have you attend any of the events organized by Edudigm or Eduscience? If yes, then mention the following:
Event/Workshop Name:

Venue:

Date:_________

Program Interested: Classroom

Correspondence

e-Learning

Test Series

Course Interested: Engineering(11&12)

Medical11&12)

Foundation(9&10

School+ (7-10)

Any queries you like to ask our experts, Please mention:

Would you like to appear for the Admission Test?


Test Date:

Yes

No

Center:

Student Name:
Class:

Exam Center:
Authorized Signatory

Exam Date:

Office Use

Tell us more

Friends/Relatives

Recent Colour
Passport Size Photo

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