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For Office Use only Form No........................................................... Control No: 903645 Application Form For Admission In Correspondence & Test Serise Courses
Purchased Course Details with Scholarship(if applicable)

Course Name Study Material Package For Pre-Medical2012

Total Fee :: 6375

Course Fee 8500

Scholarship(%) 25

Fee Payable 6375

Note: We have awarded scholarship to you in the course in which you get maximum benefit.A student can avail sholarship only in one course.

Personal Detail :

Name Father's Name Date of Birth Address City State Mobile No. Tel No with STD Old Cpian Examination IX Class X Class

Varshashankar Varshashankar Varshashankar S.Shankarappa 20 May 1994

Gender Pincode

Female

Varshashan,Kar No.416, Mangalagowri, Vidyashankara Layout, Nearshakthinagar, Mysore Karnataka 9980303609 560019NO 560019

Affix a Photograph do not staple and send two more Photograph

Email Medium Year of Passing

2009 2010 English

Past Academic Performance :

Science : 99 Maths : 99 Science : 93 Maths : 99 Level : Class : Position : Year Year Amount
6375

Details of Academic Achivement

NTSE Qualified Merit in Board

DD Details (to filled by students) :

No

DD Number
DECLARATION :

DD Date

Issuing Bank

1. I declare that I have read the Rules and Regulations of the institute and as mentioned on website and understood the contents fully. I agree to abide by them. 2. I am seeking admission in my own interest. 3. I declare that all the information furnished in this Application Form is correct to the best of my knowledge. I understand that in the event of any information found to be incorrect or false, my admission will be treated cancelled without refund of fee. 4. I shall inform the Director of Career Point about my Roll Nos. of various competitions as soon as I receive my Admit Card for those competitions. I shall not withhold this information from Career Point, who are entitled to know the results of their efforts to help me get through the exams. I understand that failing above, I shall not be considered for Career Point's reward for success. 5. I agree to abide by the policies, rules & regulations of the institute as amended from time to time. 6. In all the matters, the decision of Career Point's Director shall be final.

Signature (Parents/Guardian):

Signature (Student) :

Date : Date : Note : Please send attested copies of your class X/XII marksheet and also copies of documents supporting in your eligibility for scholarship.

Instruction
1. Don't make any correction by hand on the Form ; instead you fill a fresh form again. 2. Student eligible for merit scholarship should sumbit the fee accordingly with attested copies of supporting documents. 3. Paste your recent color photograph on Application Form. 4. Also attach attested photocopy of your recent Mark Sheet. 5. If You are an Old Cpian then send your old cpian proof also. 6. Put Application Form, DD/Challan, Recent Marksheet, along with two more photographs in an envelop and send it to 'CAREER POINT, CP Tower, Road No. 1, IPIA, Kota (Raj.) India' by Registered Post/Courier immediately to the institute so that it reaches us on or before the last date of fee deposition. 7. Write DD details on Application Form and put your signature and your parent/guardian signature on Application Form . 8. Please check the bank code at the bottom of DD (specially in case of State Bank of India and Syndicate Bank), it must be of KOTA, RAJASTHAN .

You Can Deposit the Fee in any of the following method :

1. At the Fee Deposition Counter in the institute premises :You may deposit the fee by Demand Draft or Pay Order in the institutes bank account at Bank Counter situated inside the institute premises through standard fee deposition challan available in our office. 2. By Post : o You may deposit the fee by post using bank Demand Draft of any Nationalised Bank. o The Demand Draft should be A/c payee & drawn in favour of Career Point payable at Kota (Rajasthan).

Write your Name, Fathers Name and Control Number on the backside of Demand Draft. o Student must keep photocopy of Demand Draft for future reference. 3. Anywhere in India directly in Institute's State Bank of India (SBI) account: o You may directly deposit the fee in Career Points Account at any branch of the SBI (State Bank of India) banks all over India in Account No. 30589562818 by Demand Draft or Pay Order or in cash. o To deposit the fee into SBI bank anywhere in India, student must use standard fee deposition challan given to you for download the Fee Deposition Challan. o Write your Name, Fathers Name and Control No. on fee deposition challan clearly. o After fee deposition, student must send photocopy of the Institute Copy of the Bank challan with form. o You will have to produce student copy of fee deposition challan at our admission office on the day of your reporting to the institute.
o

Important Guidelines
o

We would advise that you must deposit the fee either directly in our bank account or through Demand draft to avoid any kind of risk involved in cash handling during your travel. Please note that we do not accept any cheque. The students are advised to deposit the fee as per the schedule given in the Date Sheet and through any of the abovementioned mode to avoid any sort of inconvenience at later stage.