Test Series Enrollment Form: Side 1

SIDE 1
TEST SERIES ENROLLMENT FORM

IMPORTANT INSTRUCTION: USE ONLY BLACK BALL POINT PEN TO FILL UP THE FORM APPLICATION NUMBER (To be assigned by office) ROLL NUMBER (To be assigned by office)
STUDENT / CANDIDATES NAME (IN BLOCK LETTER ONLY)
DATE OF BIRTH
QUALIFYING DEGREE
Branch Passing Year %
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 CE 1 ME 2 EE 3 EC 4 CS/IT 5 Others 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
FATHERS OCCUPATION
0 1 2 3 4 5 6 7 8 9
EXAM CODE
0 1 2 3
Govt. Employee Class 4 Govt. Employee Class 3 Govt. Employee Class 2 Govt. Employee Class 1 Private Job Doctor Business Farming Teaching Others
GATE Test Series IES Test Series IES & GATE Test Series Others
COURSE
0 1 2
Classroom Test Series Postal Test Series Online Test Series
CATEGORIES SEX
0 1
General OBC SC ST
Female Male
2 3
MOBILE NUMBER
CORRESPONDENCE ADDRESS (IN CAPITAL LETTERS)

0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9
TEST CENTRE
0 1 2 3
Delhi Noida Hyderabad Bhopal
Fathers Name:. ...................................................................... Fathers Designation:............................................................... Fathers Contact No.:............................................................... Correspondence Address: ...................................................... ................................................................................................. Students e-mail: .................................................................... Phone (with STD Code): ........................................ Pin
Paste Photo of Candidate
MADE EASY Office:
UFPL # 50472
Delhi
Hyderabad
Noida
Bhopal
Do not staple
Corporate Office: 44-A/1, Kalu Sarai (Sarvapriya Vihar) New Delhi-110016 | Regd. Office: 25-A, Ber Sarai, New Delhi-110016 Ph: 011-45124612, 26560862, 9958995830, 9810541651 | E-mail: iesmadeeasy@yahoo.co.in Noida Office: D-28, Sector-63, Noida (Uttar Pradesh); Ph: 9958995830 Hyderabad office: 5-1-744 Bank Street, Koti (Opp. Hotel Sitara Royal) Hyderabad-95 | Ph: 040-20032005, 0-9160002324
Signature of candidate
Wrong Method
Wrong Method
Wrong Method
Wrong Method
Correct Method
SIDE 2
EDUCATIONAL DETAILS (IN CAPITAL LETTERS)

Branch of Engg. B. Tech M. Tech Name of College & City Passing Year % Marks
PROOF OF IDENTITY (Submit self attested copy of ID proof)

(*In case of absence of proof of candidate, fathers identity/address proof can be submitted)
Passport
Election I-Card
Driving License
College I-Card
PAN Card
Others (Specify)
Name of card holder: Checked by (for office use):
Card No. Signature (for office use):
PERMANENT ADDRESS (IN CAPITAL LETTERS)

....................................................................................................................................................................................... ....................................................................................................................................................................................... Phone (STD Code): ........................................................................................................... Pin: ..................................
DEMAND DRAFT DETAILS Rules & Regulations

(a) (b) (c) (d) (e) (f) (g) (h) (I) (j)
DD No.
Amount
Bank Name
City
Every student is expected to maintain discipline in and outside the classroom. In case of violation of any of the rules & regulations or discipline the institute reserves the right to disenrol any student without any refund of fee. All students are required to bring identity card daily in the class & study matter will be given through identity card only. MADE EASY reserves the right to make any alterations in its programmes/fees/faculty/venue of classes without any prior notice to anybody. However all the changes will be informed to the students accordingly. The batch once allotted at the time of admission will not be changed. Students enrolled under classroom courses will not be transferred or shifted to postal course MADE EASY students are required to submit photocopy of their IES & GATE admit cards. It is mandatory to attach two photographs & a copy of ID proof with the form at the time of admission. (The name and photo of candidate may be published in the list of successful candidates in current or future sessions for promotion of institute). Candidates who will avail the facility to pay the fees in two installments will be charged Rs. 2000/- extra within 45 days of commencement of batch. The fee will be refundable only within 5 days from announcement of batch after deducting admission charges. The student can get his seat replaced with new student within Ist three months of the batch. Replacement charges will be Rs. 2000/-. This option can be availed by students only when refund option is not available.
UNDERTAKING
I, _______________________________________ am applying for admission in __________________ program of the institute. I certify that the information given by me is true to the best of my knowledge and belief. I understand that if anything is found false/incorrect at any state, my candidature/admission to the course shall be cancelled without any refunds. I shall abide by all the rules and regulations of MADE EASY. Also, I will have no objection on publication of my photo by the institute after my selection in the competitive exam and the institute (MADE EASY) will be entitled to use my photo and details for its advertisement purpose. I have enclosed the self-attested copy of ID/Proof/Address Proof .
Date: Place: Signature of the Candidate
I ________________________ guardian* ____________ (relationship with the student) of _______________________________ (Student Name) hereby declare that I have completed all the formalities on behalf of the candidate. Also I have read and understood all the terms and conditions of MADE EASY.
* If candidate is not present, then guardian can sign.
Signature

Test Series Enrollment Form: Side 1

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Test Series Enrollment Form: Side 1

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SIDE 1

TEST SERIES ENROLLMENT FORM

STUDENT / CANDIDATES NAME (IN BLOCK LETTER ONLY)

Classroom Test Series Postal Test Series Online Test Series

CORRESPONDENCE ADDRESS (IN CAPITAL LETTERS)

Delhi Noida Hyderabad Bhopal

Paste Photo of Candidate

MADE EASY Office:

EDUCATIONAL DETAILS (IN CAPITAL LETTERS)

PROOF OF IDENTITY (Submit self attested copy of ID proof)

Name of card holder: Checked by (for office use):

Card No. Signature (for office use):

PERMANENT ADDRESS (IN CAPITAL LETTERS)

DEMAND DRAFT DETAILS Rules & Regulations

Date: Place: Signature of the Candidate

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