New Admission

Challan for New Admission 2017-18

Student / Applicant's Copy
BIRLA PUBLIC SCHOOL, Pilani
PAN : AAATB4584C

Institution's Copy
BIRLA PUBLIC SCHOOL, Pilani
PAN : AAATB4584C

Bank's Copy
BIRLA PUBLIC SCHOOL, Pilani
PAN : AAATB4584C

Date of Deposit:
Branch Name:
A/C to be credited
0036SLFEECOL
FCBPAD
Institution Name
Student Name
DDMMYYYY
Reg no. / DOB
Class /
e-mail id
Class wise fee to be accepted by TELLER
Amount

Date of Deposit:
Branch Name:
A/C to be credited
0036SLFEECOL
FCBPAD
Institution Name
Student Name
DDMMYYYY
Reg no. / DOB
Class
e-mail id
Class wise fee to be accepted by TELLER
Amount

Date of Deposit:
Branch Name:
A/C to be credited
0036SLFEECOL
FCBPAD
Institution Name
Student Name
DDMMYYYY
Reg no. / DOB
Class
e-mail id
Class wise fee to be accepted by TELLER
Amount

Including bank charges Rs.25

Including bank charges Rs.25

Including bank charges Rs.25

III to V
207925
VI to VIII
240225
IX to X
250025
XI to XII
271825
Amount in Figures:________________________________
Amount in words:________________________________
______________________________________________
Amount
Denomination
No of Notes
2000*
500*
100*
50*
20*
10*
5*
coins*
Total
Cheque / DD No.
Drawn on Bank
Payable at Branch
Transaction ID
Mobile no. of Parent

III to V
207925
VI to VIII
240225
IX to X
250025
XI to XII
271825
Amount in Figures:________________________________
Amount in words:________________________________
______________________________________________
Amount
Denomination
No of Notes
2000*
500*
100*
50*
20*
10*
5*
coins*
Total
Cheque / DD No.
Drawn on Bank
Payable at Branch
Transaction ID
Mobile no. of Parent

III to V
207925
VI to VIII
240225
IX to X
250025
XI to XII
271825
Amount in Figures:________________________________
Amount in words:________________________________
______________________________________________
Amount
Denomination
No of Notes
2000*
500*
100*
50*
20*
10*
5*
coins*
Total
Cheque / DD No.
Drawn on Bank
Payable at Branch
Transaction ID
Mobile no. of Parent

Sign of Depositor

Sign of Depositor

Sign of Depositor

Seal & Sign of Bank

For any clarification please call to: o.s 01596-242132

Seal & Sign of Bank

For any clarification please call to: o.s 01596-242132

Page 1

Seal & Sign of Bank

For any clarification please call to: o.s 01596-242132