fiziks Student

fiziks Photo
An Institute of Physics
Admission Form
Name of Student................................................ Student's Mobile No.................................

Date of Birth ........................Gender M F

Father’s Name....................................................Parent's Mobile No..................................

Mother’s Name............................................................................................................

Permanent Address.......................................................................................................

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Local Address..............................................................................................................

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E-mail......................................................................................................................
COURSES MODULE
NET/JRF JEST JNU REGULAR CORRESPONDENCE

GATE TIFR BHU WEEKEND TEST SERIES

IIT-JAM/IISc. GRE OTHERS SUMMER CLASSES
Educational Qualification
EXAM UNIVERSITY COLLEGE YEAR OF PASSING PERCENTAGE
GRADUATION
POST GRADUATION
Fee Card (Only for Classroom Programme)
Registeration 1st Instalment 2nd Instalment
Amount
Due Date
Mode of Payment
(a) Online Transfer Amount (Rs.) ……………… Date ……………Reference No. …………….......................................................
(b) DD/Cheque Amount (Rs.) ……………… Date ……………Cheque No. …..........................................................…………
(c) Cash Amount (Rs.) ……………… Date ……………

UNDERTAKING FROM THE STUDENT

This is to be stated that I ………………………………………….son/daughter of.......……………………………….resident of ………………………..am
joining fiziks institute having complete knowledge of the institute and of its rules and regulation as mentioned in the information bulletin or on its official
website.
I declare that I will abide by the rules, regulation and discipline of the institute. In case of violation of discipline and non seriousness towards
study, I can be terminated from the institute without any claim for the refund of fees. For any disciplinary action the decision of managing body of the
institute will be final. I am aware of the fact that fees once submitted to the institute will not be refunded.

Date.............................. Signature of Candidate

FOR OFFICE USE

Date of Admission.............................................Enrollment No. ....................................Batch........................

Authorised Signature