Enrolment Form - FIITJEE

E n r o l m e n t F o r m

Enrolment Number (for official use only)

( f o r C l a s s r o o m / I n t e g r a t e d S c h o o l P r o g r a m s )

2

Enrolment Form

Please Note :

v Check the availability of the program at your preferred FIITJEE centre before making a choice.

v MakeaphotocopyofthisformafterfillingtherequiredinformationandbeforesubmittingittoFIITJEE.

v Logontowww.fiitjeelogin.comtoupdateyourContactDetailsonlineusingRegistrationNumberandwebaccesscodeprintedon

your Hall Ticket.

Items required to be submitted along with this form :

v Six identical passport size colour photographs of the student (One photograph should be pasted on this page, Two on page no. 14 and

Three photographs should be submitted along with this Enrolment Form).

v One stamp size photograph (should be pasted on page no. 14).

v AdmissionTest/BBE/FTRE/FTSE/Fortunate-40HallTicket(inOriginal).

v Admission offer letter (in Original).

v Any one of the following documents :

n PhotocopyofSchoolIDcardwithphotographor

n Photocopy of last Board or School Marksheet supported by any Identity Proof of student or

n PhotocopyofTransferCertificateor

n BonafidecertificateissuedbythePrincipalofSchoolwithstudent’sphotograph

Original should be presented for verification at the time of admission.

Instruction for filling Enrolment Form

Pleasereadcarefullythe“ImportantInformationforStudents(&theirParents/LegalGuardians)”and“Declarations/Undertakings”sectionon

pageno.10,11&12respectivelybeforefillingthisForm.

In order to serve you even better, please share your valuable opinion below

What has influenced you the most to join FIITJEE ? {Pls tick (ü) options relevant to you}

FIITJEE Results / Achievements � FIITJEE Value System � FIITJEE Faculty � if yes, Name of FIITJEE Faculty : .........................................................................................

FIITJEE Student � if yes, Name of FIITJEE Student : .........................................................................................

His / Her FIITJEE Program Name : .........................................................................................

FIITJEE Study Centre Enrolled at : .........................................................................................

If any other influence (please specify) : ............................................................................................................................

.............................................................................................................................................................................................

u

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Enrolment Form

Registration Number (as mentioned on the Hall Ticket) :_______________________________________________

Study Centre : _________________________________________________________

Program Name (refer page no. 13 & 14) : ________________________________________________________________________

Program Code (refer page no. 14 & 15) : ________________________________________________________________________

Scholarship Awarded % (if applicable) : ________________________________________________________________________

Student’s Name (in Block Letters) : _______________________________________________________________________________________

Date of Birth : ________/_______/___________ E-mail ID :_________________________________________________

Mailing Address : _______________________________________________________________________________________

________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________

_________________________________________________________________________________ Pin : _________________________________

Contact No (Mobile) : ____________________________ Land Line (with STD Code) : ___________________________________

Permanent Address (if any) : _______________________________________________________________________________________

________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________

_________________________________________________________________________________ Pin :_________________________________

Contact No. (Mobile) : ____________________________ Land Line (with STD Code) : ___________________________________

School/College Last Attended / Presently Attending : _____________________________________________________________________

Address : _______________________________________________________________________________________

_________________________________________________________________________________ Pin : _________________________________

(a) Father‘s Name : ________________________________________________ Qualification : _________________________

Occupation : Business � Govt. Service � Pvt. Service � Others (please specify) : __________________________

Name of the Company / Office : _______________________________________________________________________________________

Nature of Business / Job : ____________________________ Designation : _____________________________________________

Department : ____________________________ Contact No (office) : _________________________________________

Office / Business Address : _______________________________________________________________________________________

_________________________________________________________________________________ Pin : _________________________________

E-Mail ID : ________________________________________________ Mobile No : ___________________________

(b) Mother‘s Name : ________________________________________________ Qualification : _________________________






_________________________________________________________________________________ Pin : _________________________________


Please affix the 1st passport size colour

photograph of the student here

Test date : ______/______/_____________

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Enrolment Form

(c) Details of the Local Guardian reference (Mandatory if the student is joining as a hosteler)

Local Guardian’s Name : ________________________________________________ Qualification : ________________________






_________________________________________________________________________________ Pin : _________________________________


Mailing Address : _______________________________________________________________________________________

________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________

_________________________________________________________________________________ Pin: _________________________________

(d) Details of the Sibling(s) (if applicable)

1. Name : _______________________________________________________________________________________

Class studying in : ___________________________ Enrolment No. (if enrolled with FIITJEE) :_________________________

2. Name : _______________________________________________________________________________________


3. Name : _______________________________________________________________________________________


Name of the Examination(s) Board Year of passing / appearedTotal

Aggregate Marks (%)

PCM / Science + Math

(%)

Details of the examination(s) of the class last passed / currently studying

Detail(s) of Demand Draft(s) / Pay Order(s) / NEFT

S. No. Instrument Number Dated Issuing Bank & BranchFee

Amount GST Total Amount

1

2

3

4

Total

Fee Details : Fee Plan opted (√): I □ II □ III □ IV □

Fee Plan Code : _______________________________________ (please refer course fee Annexure)

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Enrolment Form

Annexure “A”

TERMS & CONDITIONS FOR POST DATED CHEQUE(S) / NACH Mandate

I understand that if my son /daughter / ward withdraws from the Program to which he/she has been admitted

at any point of time or does not attend the Program and thus the seat given to him/her is rendered vacant,

thesamewillnot/cannotbefilledupbyanyothercandidateandavacancycreated in thebatchdue to

withdrawalofastudentafterthestartingofclassesorupto2dayspriortothesamecannotbefilledinany

case,thereforeIunderstandthatFIITJEEshallsufferirreparablelossesincaseofnon-paymentofremaining

feeof the instalment plan, hence itwill be unethical not to honour thePostDatedCheque(s) /NACH

Mandate. I have opted for instalment fee plan and have submitted the Post Dated Cheque(s) / NACH

Mandate as per the details given below.

I agree that, Iwillmakearrangement, forbelowstatedPostDatedCheque(s) /NACHMandate, toget

honoured,andwillkeepsufficientfundsonorbeforetheduedateforthesame.

Detail(s) of Post Dated Cheques (Only Local / Payable at par cheques will be accepted) / NACH Mandate

S. No. Cheque No. Dated Issuing Bank Fee Amount GST Total Amount

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

Affix one self attested passport sized

photograph of the person issuing Post Dated Cheque(s) / NACH

Mandate i.e. parents / guardian

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Enrolment Form

I further agree to get abovePostDatedCheque(s) /NACHMandate cleared, even if,my son / daughter /warddiscontinues studies at FIITJEE, irrespective of any reasons.

I am signing the above declaration in good mental / physical health. I have satisfied myself about FIITJEE. The necessary Enrolment-Forms,includingthisformwasreceivedbymeseveraldaysbeforetheactualdateofsigningtoenablemetounderstandtheimplicationsoftakingadmissionatFIITJEE.IhavetakenexpertopinionregardingmatterswhichwerenotcleartomeandIamsatisfied.

SignatureoftheStudent Father/Mother/LegalGuardian’sSignature

Name : ____________________________________________________ {Whohasissuedthecheque(s)}

EnrolmentNumber(for office use only) : __________________________ Name : ______________________________________

Date : _____________________________________________________ Address : ____________________________________

I have retained photocopy of this document for my reference before submitting it at FIITJEE.

Date : _________________________________ Father/Mother/LegalGuardian’sSignature

Place : _________________________________ Name : ______________________________________

Detail(s) of Post Dated Cheques (Only Local / Payable at par cheques will be accepted) / NACH Mandate

S. No. Cheque No. Dated Issuing Bank Fee Amount GST Total Amount

29

30

31

32

33

34

35

36

37

38

39

40

41

42

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50

Annexure “A”

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Enrolment Form

Annexure “B”

CONSEQUENCES OF DISHONOUR OF POST DATED CHEQUE(s) / NACH Mandate

Iunderstandthatnon-clearanceofanyofthePostDatedCheque(s)/NACHMandate,submittedforpaymentoffees(oninstallment

basis)asmentioned in theEnrolment-Formandannexure“A” ispunishableunderSec.138of theNegotiable InstrumentAct. I

understand that FIITJEE shall be entitled to proceed and initiate appropriate legal action against me, to recover the amount of the

PostDatedCheque(s)/NACHMandatealongwiththelegalexpensesandoutofpocketexpensesincurredbyFIITJEE.

IncaseanyofmyPostDatedCheque(s)/NACHMandatebouncesforanyreasonwhatsoever,IundertaketosubmitaDD/Pay-

Orderinfavourof“FIITJEELtd.”payableatNewDelhi,withinfourdaysofthebouncingoftheCheque(s)atmybank,togetherwith

Rs.500/-(Rupeesfivehundredonly)asdefaultmoneyalongwithlatepaymentofRs.50/-(Rupeesfiftyonly)perdayupto10(Ten)

days from the due date of payment of instalment after which my son / daughter / ward shall be debarred from classes without any

further notice and I shall have no claim for refund of fees or any support in studies besides Legal action inter alia action under Section

138oftheNegotiableInstrumentActmaybeinitiatedagainstme/us.


Name : ____________________________________________________ {Whohasissuedthecheque(s)}

EnrolmentNumber(for office use only) : __________________________ Name : ______________________________________

Date : _____________________________________________________ Address : ____________________________________

_____________________________________________

_____________________________________________


Date : _________________________________ Father/Mother/LegalGuardian’sSignature

Place : _________________________________ Name : ______________________________________

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Enrolment Form

Excellent Good Average Below Average Low Unknown

Sincerity

Leadership

Imagination

Emotional stability

Ability to work with others

Ability to work hard

Perseverance

Annexure “C”

PARENT DATA SHEET

(CONFIDENTIAL)

DearParent/ Guardian,

The right and accurate feed back of your ward/student will give us an opportunity to understand the student better which will help us

inprovidingbettersupport&education.Thisinformationwillbeconfidential.

1. NameoftheStudent : ______________________________________________________________________________

2. Father’s/Guardian’sName : ______________________________________________________________________________

3. RelationwithStudent : ______________________________________________________________________________

4. Howwouldyouratethestudentinthefollowingcharacteristics?(√theappropriate)

6. Whatisthestudent’sclassrank? : ____________________________________________________________________________

7. Somegiftedindividualsmakemediocrescholasticrecords.Isthestudent’srecordanaccurateindexofhis/hercapabilities?

Yes/No

If no, state why? : ______________________________________________________________________________

8. Whatisthestudent’sbiggestweakness?: ______________________________________________________________________

9. Havetherebeenanymajorchangesinthestudent’sattitudetowardsstudiestillnowatanytime,ifsoillustrate,whenandwhy?

(You may attach a blank page if required.)

10. Pleasementionanyotherinformationrelatingtothestudent,whichhelpmakeFIITJEEunderstandthestudentbetter.

________________________________________________________________________________________________________

________________________________________________________________________________________________________

11. My son / daughter / ward has a sound moral character & sense of responsibility. He/she also has good physical and mental health

tosuccessfullycopeup&completehis/herstudiesatFIITJEEandfulfillallterms&conditions.

Father/Mother/LegalGuardian’sSignature

Date : _________________________________

Place : _________________________________

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Enrolment Form

Annexure “D”

Kindly do not take admission at FIITJEE if the clauses of the declaration on the Enrolment Form on page no. 11 & 12

is not agreeable to you.

NameoftheStudent : _________________________________________________________________________________________

NameoftheFather/Parent/Guardian: ___________________________________________________________________________

Residentialaddress : ___________________________________________________________________________________________

Specific Declarations (10 & 22) are being reproduced hereunder :

Declaration 10 :

In addition to the above, I understand without any ambiguity, that the fee once paid is not refundable at all, whatever the reasons be,

neitherisitadjustabletowardsanyotherexistingcoursesatFIITJEEoranyyettobelaunchednortowardsthefeeofanyotherexisting

or prospective student.

Declaration 22 :

I/We,theparent/guardianand/orthestudent,herebyseverallyandjointlydeclareunambiguouslythatI/Wehavereadandunderstood

alltheclausescontainedinthisEnrolmentform,AnnexureandDeclarationsandagreetoabidebythemwithoutanyreservationor

ambiguity.

I/We further declare that the above named student is taking admission in the ____________________________________________

___________________________________________________(course opted for) having considered everything material and on his/her

own sweet will and with the permission of the Father / Mother / Legal Guardian without any coercion from any side.


Name : ____________________________________________________ Name : ________________________________________

EnrolmentNumber(for office use only) : __________________________ Address : _______________________________________

Date : _____________________________________________________ ________________________________________________


Date : _______________________________ Place : _____________________________ Father/Mother/LegalGuardian’sSignature

Instruction : Afterfilling-upannexure“A”,“B”,“C”&“D”pleaseretainphotocopyofthesamebeforesubmittingattheFIITJEE

Checklist : 1.DemandDraft(s)/PayOrder(s)/NEFTforthefee �

2.Local/atparpostdatedcheque(s) �

3.NACHMandate �

4.EnrolmentFormdulyfilledin �

5.Annexure“A”to“D” �

6. Colour Photographs:

(a) Passport size (Six) �

(b)Stampsize2.5x2cm.(One) �

7.AdmissionTest/BBE/FTRE/FTSE/Fortunate-40HallTicket(inOriginal) �

8. Admission offer letter (in Original) �

9. Any one of the following documents :

(a)PhotocopyofSchoolIDcardwithphotographor �

(b) Photocopy of last Board or School Marksheet supported by any Identity Proof of student or �

(c)PhotocopyofTransferCertificateor �

(d)BonafidecertificateissuedbythePrincipalofSchoolwithstudent’sphotograph �

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Enrolment Form

IMPORTANT INFORMATION FOR STUDENTS (and their parents / legal guardians)

1. BeforeTakingAdmission-EachCandidate,His/HerParents&LegalGuardiansarerequiredto-

(a) GothroughtheFIITJEELeaflet/Brochure/InformationBooklet,wordofadvice,selectionletter&websitethoroughly.Otherthanthese

no other verbal assurance of any kind is given by FIITJEE.

(b) ItisadvisedthatstudentundergoesacomprehensiveMedicalExaminationtoensurethathe/sheisphysically&mentallyfittotakethe

rigors of preparing for a competitive exam including but not limited to JEE Advanced & JEE Main etc. as the case may be.

(c) MeetfewFIITJEEstudentssuccessful inIIT-JEE/AIEEE{nowJEEAdvanced&JEEMainrespectively},NTSEetc&learnwhatmade

themsuccessful.WhatwasthecontributionofFIITJEE intheirsuccess? Alsomeeta fewFIITJEEstudentsnotsuccessful in IIT-JEE/

AIEEE{nowJEEAdvanced&JEEMainrespectively}/NTSE&learnwhytheycouldnotqualifyIIT-JEE/AIEEE{nowJEEAdvanced&

JEEMainrespectively}/NTSE.

WehighlyadvisethatyoualsotalktoNon-FIITJEEstudentsbothsuccessfulinIIT&theunsuccessfulones,toformaclearopinionregarding

what a coaching institute can do for you.

Please do not take admission at FIITJEE if you think FIITJEE is not the best for JEE coaching.

Anintelligentstudenthavingaptitude&analyticalskillsforJEE/NTSEetchastohaveselfstudyforatleast3hrs.foreveryhourtaughtat

FIITJEE.Needlesstosayifyouhavenotbeenahighlyanalyticalstudentyouhavetoputinevengreaterefforts.

For success in JEE, it is also important to have excellent performance In XII Board Exams. Furthermore, JEE is a different exam where you

will feel lost if you do not focus on fundamentals and/or you do not develop / have high analytical skills. Any amount of effort will be in vain

without high analytical skills. Admission at FIITJEE does not mean that you have high analytical skills. FIITJEE teachers will guide you in such a

way that your fundamentals are strengthened and you can improve your analytical skills tremendously, whether it happens or not will depend

upon you. The only way to develop strong fundamentals & improve your analytical skills & therefore your chances to get through JEE Main /

JEEAdvanced/NTSE,etcwithexcellentSchool/Boardperformanceistosolveeach&everyprobleminFIITJEEassignmentsyourself.You

mayhavetomakeseveralattempts&evengobacktoyourbasicstorefreshthemtosolveaparticularproblem.Itisthisintensity&quality

ofeffortwhichwillhelpyoudevelopgoodanalyticalskills.Ultimatelyastudentwhoisenrolledwithinstitutewillhavetocontinuouslywork

hard and must be regular in studies. In case, the teachers feel that the student is not working hard, is creating indiscipline in the Institute,

is irregular in attendance or is not responding properly, he/ she may be expelled from the institute. The decision of FIITJEE in this regard

will/shallbefinalandbindingonthestudents.Nofeeorpartofthefeewillberefundedinsuchcase.

In the end remember, while anyone can appear in JEE Main / JEE Advanced or pretend to prepare but only the ones who walk the right path will

succeed. FIITJEE has no magic potion to make you successful. Preparing to achieve optimum performance in both Boards & JEE will challenge

every bit of your mental & physical energies.

2. FIITJEEstartsmakingarrangementsof infrastructure, faculty&other resourcesabout6monthsbeforecommencementoffinancial year.

FIITJEEadmitsstudentsasperitscapacityplans,(subjecttounforeseencircumstances&usualorganizationalrisks)thereforeeachstudent

taking admission has to pay complete fee under all circumstances i.e. even if he/she discontinues for any reason whatsoever or parents /

guardiansbetransferred.Notallstudentswhositinouradmissiontestareofferedadmissionthereforeyou&parentshavetobeverysure

before taking admission as you have to pay complete fee under all circumstances.

OnceaclassstartsFIITJEEdoesnotadmitanystudents.Therefore,anyvacancycreatedbyastudentleavingcannotbefilledup.SinceFIITJEE

has to source infrastructure, faculty etc. in advance, loss of fees of students leaving after taking admission will compel the institute to enhance

fees for next batch of students which is unfair to them. Therefore, students / parents must clearly understand this important aspect and take

admissiononlyiftheyarefullysatisfied.

3. Any change in government rules, regulations, policies pertaining to the courses of competitive exam such as JEE Main / JEE Advanced,

Olympiads,KVPY,NTSEetc.whichmayrendertheseexamsasdeletedorcancelled.Insucheventuality,FIITJEEshallnotbeheldresponsible

in any manner whatsoever. However, FIITJEE shall take all necessary steps to protect the interest of students.

Student’s Signature Signature of Father / Mother / Legal Guardian

Name : _________________________________ Name : _________________________________

Date : __________________________________ Date : __________________________________

Place : __________________________________ Place : __________________________________

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Enrolment Form

Kindly do not take admission at FIITJEE, if the following declarations are not agreeable to you

Please read the Declarations / Undertakings carefully before signing

Declaration:

1. I/We hereby declare that the information furnished on this enrolment form etc. is correct to the best of my knowledge and belief.

2. IamtakingadmissioninFIITJEEwiththeconsentofmyFather/Mother/LegalGuardianandafterbeingsatisfiedinallrespects.

3. I/We undertake that the information / details furnished / given by me/us are correct and if any discrepancy is found in the said details / information, atanystageofmyassociationwithFIITJEE,FIITJEEmaytakeanylegalactionagainstme/uswhichFIITJEEmaydeemfitincludingbutnotlimitedto my (student) expulsion from the institute and I/We shall not be entitled for any refund of fees / claim / compensation / damages etc.

4. I/Weundertakethat I/Weshall furnish / submit /complete theremainingrequireddocumentsand formalitiesbyat least twodaysprior tocommencement of course program. However if I fail to do so, FIITJEE may not allow me to attend the classes, unless otherwise allowed by FIITJEE in writing. I/We further undertake that I/We shall not claim any refund of fees/ cost of study material etc. already paid on ground of inability to furnish/complete documents / formalities.

5. I/We understand and acknowledge that FIITJEE does not give any guarantee / promise / assurance for success in JEE Main / JEE Advanced / XIIboards, inspiteofprovidingthebestteachingfacultyandmethodology,duetohigh-endcompetitionand limitednumberofseats in IIT. I undertake that I shall not hold FIITJEE responsible if I may not succeed the JEE or other competitive exam.

6. I/Weunderstandandacknowledgethatpreparationfor JEErequiresexhaustivehardwork,extensivestudy,motivationandselfconfidence. IundertakethatIshallfollowtherulesandteachingmethodologybesidestudyandpracticerigorouslywithoutloosingself-confidence.

7. I/WeclearlyunderstandthatFIITJEEoncompletionoftopicstobecoveredbyFIITJEEinClassXIasperit’splan,willdogoalrefocusingforallTwoYearClassroomProgramstudentsincludingPINNACLEprogramstudentstohelpeachstudentachievemaximumpossiblesuccess.Thismeans that some students based on their performance, may have to predominantly focus on exams other than JEE (Main & Advanced).

8. I undertake that if I leave the institute midway before completing the full course for any reason whatsoever, including but not limited to transfer of my Father / Mother / Legal Guardian / ill health of myself or any other member of the family or my admission in any institute / course / engineering college etc., or my studentship is cancelled because of misconduct etc., I or my Father / Mother / Legal Guardian shall not be entitled for refund of fees.

9. I/WeundertakethatonceI(student)jointhestudycentre/programofferedbyFIITJEE,I/Weshallnotbeentitledtochangethestudycentre/programnorwillIbeentitledtorefundoffees.However,ifFIITJEEfindsmecompetent/eligibleforthehighercourse/program,itmayconsidermyrequestforchangeofprogramsubjecttopaymentofdifferenceofcourse/programfee.

10. Inadditiontotheabove,Iunderstandwithoutanyambiguitythatthefeeoncepaidisnotrefundableatall,whateverthereasonsbe,norisitadjustabletowards any other existing courses at FIITJEE or any yet to be launched nor towards the fee of any other existing or prospective student.

11. IundertakethatIshallabidebytherules&regulationsofFIITJEEorFIITJEE’sassociatedschools.Iundertakethatincaseofanydisputerelatingtobreach/violationofanyoftheRules&RegulationsofFIITJEEorFIITJEE’sassociatedschool,thedecisionoftheManagementofFIITJEEshallbefinalandbindinginallcircumstancesandsituations,whatsoever.

12. ItisunderstoodthatthisadmissionisvalidonlyforthecourseandthedurationforwhichIamtakingadmissionandI/We(thestudentandtheParents/LegalGuardian)shallnotclaim/requestforadmissiontoandadjustingthefeestoanyothercourseorduration.

13. I/We acknowledge that the course materials provided to the student by FIITJEE during the course of study at FIITJEE are the intellectual property of FIITJEE and solely for personal purposes and not for commercial use. I further undertake that I shall not make copies of the study material provided by FIITJEE nor shall provide / give / distribute it to anyone else.

14. FIITJEEhasenjoyedgreatrelationshipwiththestudentsandparents.Almostallstudentsineveryclassandeveryprogramhavebeensucceedingin coping up with huge pressure of simultaneous preparation for competitive exams along with school / board studies. In few cases where some students do discontinue because they are not able to cope up with simultaneous competitive exam preparations along with school / board studies, the parents have continued to support the good work of FIITJEE.

Whatwillconstitutedeficiencyinservice?

Iftheaveragefeedbackoftheparticularsubjectteachergoesbelow70%intheFeedbackForm“Annexure-FB”(attachedherewith),thenthesaidteacherwillbeconsideredtoteachbelowtheminimumFIITJEEStandard.Ifateachergetslessthan70%feedbackintwoconsecutiveperiods then his/her teaching will be considered unsatisfactory by high FIITJEE standards.

15. I/WehavefullysatisfiedourselveswithregardstoqualityandexcellenceofteachingatFIITJEEfromallavailableinformation/sourcesandhavedecided to study only at FIITJEE. I/We wish to pay the entire fees as per the Fee Plan ____________ (Fee Plan I / Fee Plan II / Fee Plan III) option (the same is signed by me & the student and is attached with this enrolment form) at our own sweet will and convenience without any pressure / coercion from any one.

16. I/WeagreetosubmitaphotocopyoftheJEEAdmitCardofthestudentby25thMarchoftheconcernedJEEyeartoFIITJEEandadmitcardofvarious Other Engineering Entrance Exam as soon as I/We receive the same from the examining body.


Name : _________________________________ Name : _________________________________

Date : __________________________________ Date : __________________________________

Place : __________________________________ Place : __________________________________

DECLARATIONS / UNDERTAKINGS

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Enrolment Form

17. I/We fully understand that FIITJEE is giving the scholarship because the student is expected to bring laurels to FIITJEE and will spread good word ofmouthamongthestudents. I/WeundertakethatI /weshall /will fullycooperatetoachievethisobjectiveincludinggivingtheJEEAdmitCardbefore25thMarchoftheconcernedJEEyearandsigningtheletterofappreciationlaudingFIITJEEefforts.I/Wefurtherundertakethat I/We shall attend the seminars / workshops / felicitation / interview etc. conducted by FIITJEE after achieving rank by the student; however FIITJEE shall alone bear the entire cost and expenses in respect thereof. I further undertake to endorse the efforts and contributions made by FIITJEEInachievingtherankwhilegivingInterviewstothemedia(print/electronic/web).IfwefailtogivetheJEEadmitcardby25thMarchofthe concerned JEE year, FIITJEE will have the right to discontinue the scholarship and/or recover the scholarship with interest and the student / parents/legalguardianwillhavenoobjectiontothesame.

18. I/We (student and the parents) declare that FIITJEE will have sole claim over the outstanding academic performance of the student and further agree to give a letter of appreciation to FIITJEE for the outstanding result in form of a Letter, a Video Interview or any other forum / format that FIITJEEdeemsfit.

19. I/We undertake and acknowledge that incase I/We indulge in any kind of litigation with FIITJEE, I/We shall not be entitled for any Awards / Rewards/Scholarships/Benefitsetc.fromFIITJEEandshallrefund/returnsuchAwards/Rewards/Scholarships/Benefitsetc.Ifavailedbythestudent, within a period of 15 days, failing which FIITJEE shall be entitled to recover the same through the appropriate court / forum alongwith interest, damages and cost of litigation.

20. I/WeundertakethatI(student)shallnotindulgeinanyillegal/unethical/unprincipled/immoral/corrupt/dishonestactivitieswhichmaycause loss of property, reputation and goodwill of FIITJEE. I/We further undertake that I/We shall compensate for/ indemnify against any loss /damage caused to FIITJEE.

21. IfastudentisawardedscholarshipbyFIITJEEanddoesnotperformatasimilarlevelafterjoiningFIITJEEClassroom/IntegratedSchoolProgramthenaprobemaybelodgedtofindoutifthestudentgotscholarshiponhis/herownmeritorbyusinganyunfairmeans.ParentsandGuardiansofthe student will be liable to pay back full fee of the program (that the student is enrolled for) with interest plus expenses towards investigation and alsoacompensationofRs.10Lacs,iftheinvestigatingcommitteeconcludesthatstudenthadnotsecuredthescholarshiponhis/herownmerits.

Therefore, if your child has got scholarship using unethical means please do not take admission at FIITJEE.

22. I/We,theparent/guardianand/orthestudent,herebyseverallyandjointlydeclareunambiguouslythatI/WehavereadandunderstoodalltheclausescontainedinthisEnrolmentform,AnnexureandDeclarationsandagreetoabidebythemwithoutanyreservationorambiguity.

23. I/We furtherdeclare that the studentnamedonpageno.3 is taking admission in theprogramasmentionedonpage3havingconsideredeverything material, on his/her own sweet will after giving due consideration to rigors of time, distance and studies ahead and with the permission oftheFather/Mother/LegalGuardianwithoutanycoercionfromanyside.FurtherI/Weunderstandthatthestudentisrequiredtoworkhardtoattaintheaveragestandardofthebatchallottedinordertocopeupwithstudiesandputinextraeffortsiflaggingbehindinanysubject/topic.

24. I/Wefurtherundertaketoensurethatcheques/draftsincludingpostdatedcheques/NACHMandateifanygivenbyuswillbehonouredbyourbankers.Intheeventofthesecheques/draftsbeingdishonoured,FIITJEEisatlibertytoinitiateanyactionagainstusincludinglegalproceedingsundersection138ofNegotiableInstrumentsActorotherappropriatelaw.

25. IknowthatregisteredofficeofFIITJEELtd.issituatedatNewDelhi.

26. IpromisetoabidebyallrulesandregulationsofFIITJEEdeclaration,inletterandspirit.

27. Intheeventofanydisputebetweenthepartiesregardingtheinterpretationofclausesofenrolmentformoranyclaimetc.arisingoutoftaking admission in FIITJEE, the matter shall be referred to the Sole Arbitrator appointed by FIITJEE Ltd. The arbitration proceedings shall beconductedinaccordancewiththeprovisionsoftheArbitration&ConciliationAct,1996andstatutorymodificationthereof&rulesmadethereunder.ItisfurtheragreedthatinspiteofthefactthattheSoleArbitratormaybeknowntoanyoftheDirectorsorshareholdersandthathemayhavebeendealingwiththeCompanyorhadoccasiontodealwithanymatterofthisagreementshallnotdisqualifyhim.EveniftheArbitratormayhaveexpressedopinioninsimilarmatterearliershallalsonotrenderhimdisqualified.Thearbitratorsoappointedshallnot be incapacitated for reasons of their being the employee or an associate of FIITJEE Ltd. or Group / Subsidiary Companies, and for reasons ofhavinganypriorlinkagewiththecompany.Thedecisionofthearbitratorshallbefinal&bindingonbothparties.ThevenueofArbitrationshallbeDelhi/NewDelhionly.

28. Subject to clause27 above, I/We (the student and theFather /Mother / LegalGuardian)understand that in caseof any legal dispute, thejurisdictionwillbeanappropriatecourt/foruminDelhi/NewDelhionlyandI/Weshallnottakerecoursetosuchanactioninanyothercourt/forumoranywhereelse.IncaseIdo,Ishallinformtherelevantcourt/forumregardingthisjurisdictionconstraint.

29. Ihavereadtheabovecarefullyandhaveunderstooditclearly.I/WehavealsoreadthecurrentFIITJEEBrochurecarefullyandhaveunderstooditclearly.IhavekeptaphotocopyofallthepagesofthisenrolmentformincludingthisdeclarationandAnnexures“A”,“B”,“C”&“D”formyfuture reference and timely compliance.

Additional declaration for Integrated School Program Students only :

30. I/We(Studentandtheparent)am/arejoiningFIITJEE’sIntegratedSchoolProgramonlyaftersatisfyingmyself/ourselvesaboutthestructureofprogram.I’llfullyabidebytherulesandregulationsoftheschool.IalsounderstandthatintheeventIamexpelledfromtheschoolonany

disciplinarygroundI’llraisenoclaimfromFIITJEEforanyacademicand/orfinanciallossincludingcoursefee..


Name : _________________________________ Name : _________________________________

Date : __________________________________ Date : __________________________________

Place : __________________________________ Place : __________________________________


13

Enrolment Form

(DeclarationtobegivenbythestudentifFather/Mother/LegalGuardiandoesnotresideintheStudyCentreCity,neitherdoeshe/she have any Local Guardian)

As my Father / Mother / Legal Guardian do(es) not reside at _______________________________________ and I have no Local

Guardian. I own all responsibility on their / his / her behalf.

Date : _________________________________ Student’s Signature : ________________________________

Place : _________________________________ Name : _______________________________________________

(To be struck off, if Not Applicable)

(DeclarationtobegiveniftheEnrolmentformisnotsignedbytheFather/Mother/LegalGuardianatthetimeofadmission)

I have received an extra copy of this Enrolment Form, which I shall send to my Father / Mother / Legal Guardian and submit to

FIITJEE within 15 days with his/her signatures. If I fail to do so unless a further relaxation has been given by the FIITJEE authorities

in writing, my admission shall be liable to be cancelled and I or my Father / Mother / Legal Guardian shall have no claim for refund

of fees or any other compensation of any type.

Date : _________________________________ Student’s Signature : ________________________________

Place : _________________________________ Name : _______________________________________________

(To be struck off, if Not Applicable)

For Office use only

Check list for the Accountant / Admission Coordinator.

v NameoftheAccountant/AdmissionCoordinator: _____________________________________________________________

v TheApplicationformiscompleteinallrespectwithAnnexureA,B,CandDdulysignedbythestudentandtheparent.

v The details of the scholarship offered.

o Cash scholarship (If any) : _______________________________________________________________________________

o Fee Waivers offered (If any) : ___________ %on ____________________________________________________ ground

o Hostel fee waiver (If any) : ______________________________________________________________________________

v Thecertificatespertainingtoscholarshipareattached.

v 6 passport size and one stamp size photograph are attached.

v Late payment charges / Admin. charges duly calculated and collected.

v Thefeechargedhasbeendulymatchedandverifiedwiththefeebrochure.

v SignaturesonPDCs/NACHMandateandonAnnexureA,B,CandDaresame.

v IsthestudentjoiningasaHosteler?IfyesdetailsoftheLocalGuardianareprovided.

v The student has been offered the admission after selection in Admission test only.

DeclarationbytheAccoutant/AdmissionCoordinator.

IhaveverifiedtheentireEnrolmentformandcheckedallthepointsmentionedabove.TheEnrolmentisrecommended.

Date : _______________________ Place : _________________________ Signature of the Account / Admission Coordinator


14

Enrolment Form

Program NameProgram

Code

For Admission in Class 6th

LITTLE GENIE - One Year Foundation Program - Regular Week Contact Classes 6051

LITTLE GENIE - One Year Foundation Program - Weekend Contact Classes 6052

LITTLE GENIE - One Year Foundation Program - Sunday Contact Classes 6053


UDAYA Plus - Two Year Integrated School Program 7010

UDAYA - Two Year Classroom Program - Regular Week Contact Classes 7051

UDAYA - Two Year Classroom Program - Weekend Contact Classes 7052

UDAYA - Two Year Classroom Program - Sunday Contact Classes 7053


UDAYA - One Year Classroom Program - Regular Week Contact Classes 8051

UDAYA - One Year Classroom Program - Weekend Contact Classes 8052

UDAYA - One Year Classroom Program - Sunday Contact Classes 8053


SUPREME - Four Year Integrated School Program for JEE Advanced 9020

ATHENA - Four Year Integrated School Program for JEE Main 9022

Four Year Classroom Program for JEE Advanced - Regular Week Contact Classes 9061

Four Year Classroom Program for JEE Advanced - Weekend Contact Classes 9062

Four Year Classroom Program for JEE Advanced - Sunday Contact Classes 9063

Four Year Classroom Program for JEE Advanced - Regular Week Contact Classes (Admission only for Class IX and X) 9064

Four Year Classroom Program for JEE Advanced - Weekend Contact Classes (Admission only for Class IX and X) 9065

Four Year Classroom Program for JEE Advanced - Sunday Contact Classes (Admission only for Class IX and X) 9066

Four Year Classroom Program for JEE Main - Regular Week Contact Classes 9071

Four Year Classroom Program for JEE Main - Weekend Contact Classes 9072

Four Year Classroom Program for JEE Main - Sunday Contact Classes 9073


Three Year Classroom Program for IIT-JEE - Regular Week Contact Classes 1061

Three Year Classroom Program for IIT-JEE - Weekend Contact Classes 1062

Three Year Classroom Program for IIT-JEE - Sunday Contact Classes 1063

Three Year Classroom Program for JEE Advanced - Regular Contact Classes (Admission only for Class X) 1064

Three Year Classroom Program for JEE Advanced - Weekend Contact Classes (Admission only for Class X) 1065

Three Year Classroom Program for JEE Advanced - Sunday Contact Classes (Admission only for Class X) 1066

Classroom / Integrated School Programs

Please affix the 2nd passport size colour


Please affix the 3rd passport size colour


Please affix the stamp size colour


Please submit 3 additional passport

size colour photographs with this

Enrolment Form

15

Enrolment Form

Program NameProgram

Code


PINNACLE - Two Year Integrated School Program for IIT-JEE 1110

PINNACLE - Two Year Integrated Program for IIT-JEE (Jr. College) 1112

Two Year Classroom Program for JEE Advanced - Regular Week Contact Classes 1151

Two Year Classroom Program for JEE Advanced - Weekend Contact Classes 1152

Two Year Classroom Program for JEE Advanced - Sunday Contact Classes 1153

Two Year Classroom Program for JEE Advanced - Special Weekend Contact Classes 1154

Two Year Classroom Program for JEE Advanced - Regular Week + Sunday Contact Classes 1155

Two Year Classroom Program for JEE Main - Regular Week Contact Classes 1171

Two Year Classroom Program for JEE Main - Weekend Contact Classes 1172

Two Year Classroom Program for JEE Main - Sunday Contact Classes 1173

Two Year Classroom Program for JEE Main - Special Weekend Contact Classes 1174

Two Year Condensed Classroom Program for IIT-JEE -Regular Week Contact Classes 1161

Two Year Condensed Classroom Program for IIT-JEE -Weekend Contact Classes 1162

Two Year Condensed Classroom Program for IIT-JEE - Sunday Contact Classes 1163


One Year Classroom Program for JEE Advanced - Regular Week Contact Classes 1251

One Year Classroom Program for JEE Advanced - Weekend Contact Classes 1252

One Year Classroom Program for JEE Advanced - Sunday Contact Classes 1253

One Year Classroom Program for JEE Advanced - Regular Week + Sunday Contact Classes 1254

One Year Classroom Program for JEE Main - Regular Week Contact Classes 1271

One Year Classroom Program for JEE Main - Weekend Contact Classes 1272

One Year Classroom Program for JEE Main - Sunday Contact Classes 1273

One Year Classroom Program for JEE Main - Regular Week + Sunday Contact Classes 1278

Special One Year Weekend Classroom Program 1261

Special Weekend Classroom Program for IIT-JEE 1262

Intensive Contact Program for JEE Advanced 1264

Special One Year Classroom Program for JEE Main & Advanced 1266

Intensive Contact Program for IIT-JEE 1281

Super Rank Enhancement Classroom Program for IIT-JEE 1282

Crash Course for JEE Main 1286

For Admission After Class 12th

One Year Extended Classroom Program for JEE Advanced - Regular Week Contact Classes 1351

One Year Classroom Program for JEE Main - Regular Week Contact Classes 1371

One Year Classroom Program for JEE Advanced - Regular Week Contact Classes 1361

Special Classroom Program (for Ex-FIITJEEians) 1362

Intensive Contact Program for IIT-JEE 1381

Super Rank Enhancement Classroom Program for IIT-JEE 1382

Crash Course for JEE Main 1386

Classroom / Integrated School Programs

Publ

ishe

d in

Dec

embe

r, 20

20

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Enrolment Form - FIITJEE

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Transcript of Enrolment Form - FIITJEE