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VMC

This document is a personal information form for admission to Vidyamandir Classes coaching programs. It requests information such as the student's name, date of birth, gender, school details, address, parents' contact information, preferred location and batch for coaching, and payment details. The form is to be filled in block letters and includes fields to paste a passport photo and select the admission test and target program.

Uploaded by

Anubhav Gupta
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
314 views

VMC

This document is a personal information form for admission to Vidyamandir Classes coaching programs. It requests information such as the student's name, date of birth, gender, school details, address, parents' contact information, preferred location and batch for coaching, and payment details. The form is to be filled in block letters and includes fields to paste a passport photo and select the admission test and target program.

Uploaded by

Anubhav Gupta
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Personal Information form

Admission test Roll No:


(If you have appeared)

Please paste Passport


size photograph of the
student here

Choose program (please tick )


IITJEE 2014 1 year XII studying
AimiiT 2017 3 year

IITJEE 2016 2 year


IITJEE 2018 4 year

Choose Batch and location (please tick )


Batch
Founder - X
Founder

Target - X
Regular

Location
Anand Vihar
Bhubneswar
Chandigarh
Faridabad

Gurgaon
Safdarjung
Pitampura
Others (please specify)____________

Student details (please fill in BLOCK LETTERS)


MM
YYYY
First Name:_________________ Last name:_________________ Date of birth: DD
Gender: M
F
Present school: __________________________________________________
Mobile No: ____________________ Email: ____________________

Address details (please fill in BLOCK LETTERS)


Address line 1: ___________________________________________________________________
Address line 2: ___________________________________________________________________
City: _______________ State: _______________ Pin code: _________________
Residence phone: STD code: _________ Phone: _________________

Parents contact details (please fill in BLOCK LETTERS)


Fathers Name: ________________________
Mothers Name: ________________________
Fathers Email: ____________________________Mothers
_______________Mothers Email: ___________________________
Fathers Mobile: __________________
Mothers Mobile: __________________
Fathers Profession: _____________________
Mothers Profession: _____________________
Fathers Address: ________________________ Mothers Address: ________________________
(Professional)
________________________ (Professional)
___________________
_______________________

Payment details (For OFFICE USE ONLY)


ONLY
(to be filled by VMC staff)

Payment mode (please tick ): Cash:

Cheque:

DD:

EFT:

Pay order:

Drawn on bank: ________________________ Cheque/DD/Pay order No: _______Dated: ________


Other comments ___________________________________________________________________
Received by: ______________________Received on: _______________________
Personal Information form
Vidyamandir Classes

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