Details of Counselling ( to be captured by counsellor)

Date:
Registration Number:
Name of the Student:
School/College

Category:
Student/ Parental clarity
where the student will go

GM/ OBC/ SC / ST
on
Decided/ Undecided
Engineering: IIT/NIT/BITS/KCET
Medicine: National level/
AIPMT/KCET/COMEDK
Pure Science: IISC/IISER/IIT/BITS
Others ( Specify):

Preferred Board for

Plus 2

Preferred Institution/s for

Plus 2

Preferred combination

PU/CBSE/ISC/ Others

PCMB
PCM with CS / Electronics
Language 1 Kannada/ Sanskrit/ Hindi
Language 2 - English

5
6
7

Students willingness/motivation
to work to achieve goal
Mode of Commute to
College
Financial Needs of the Parent

High/ Medium / Low

Public transport/ Cycle / Scooter/ Walk / Drop by
family/ require school transport
Installment / Full payment
Payment mode: Cheque /CARD/DD/CASH

Objections / Queries raised by the

parent

Objection Handling
/ Explanation of queries

10 Explanation

of features of Recorded Audio -Video of synopsis

program / additional support
provided
Chapter wise online testRecorded Solutions to Modules
Online Support to KVPY
( Explain benefits of KVPY)
Performance/ Attendance on line
Dossier
Mentoring sessions

11 Program recommended

IIT Achiever/ MEDICAL EXCEL / PreUni plus

Delivery format: Integrated/Regular/B@H

12 Additional

program required
( Support only through B @ H)
Yes/No
13 Explained fee pattern,
installments(if any)
14 Explained Terms and Conditions Yes/No

15 Final Course offered and

accepted by Parent/ Student

16 Date Of Admission
17 Assessment of Counsellor

Counselled By:

Counsellor Signature: