For

 Official  use  
COMPUTATIONAL COURSES Receipt  no.:    

  ENROLLMENT FORM Date  Regd.  :    

Enrollment  
Enrollment for  the  
for ythe
ear  year
   :        2 01  
7    /2018
: 2019
2018                                                                                  CCity
it y::Chennai
CHENNAI                                                  Centre:                                                                          
PLEASE  FILL  UP  ALL  PARTS  OF  THE  FORM  VERY  CAREFULLY  IN  BLOCK  LETTERS  

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your  recent  passport  
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Date  of  Birth              :                                                                                                                                                    _____________________________  
                                                                                                                                               
Father’s  Name      :                                                                                                                                        _____________________________                                                                                                                                              
                        of  the  Candidate  
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ACADEMIC  BACKGROUND                  Aggregate  college  percentage:      
Highest  Qualification  (Tick  the  correct  option):                    BE/B.Tech                      ME/M.Tech                      MCA                    M.Sc                      Other  
Currently:  Working  at  _____________________________                      Studying                              Graduated  but  not  working  
Full  Name  of  Graduating  College:    
City  of  Graduating  College:    
Year  of  passing  out  graduation:      
ENROLLMENT  DETAILS     FOR  OFFICE  USE  
PACKAGES:                              MATLAB                                    CATIA                                        CFD  -­‐  ANSYS                              
BATCH  ID      
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  PAYMENT  MODE   AMOUNT  PAID          RS.    
    CASH        
Online  Transfer  Reference  No.    
  CASH  DEPOSIT  IN  AXIS  BANK  
  DD  No.      
  ONLINE  TRANSFER    
Transaction/Transfer  Date      
    DD  
 
CHECK  LIST  
 To  enroll  please  send/submit  the  following  :  
1. Completely  filled  up  Enrollment  form  
2. Two  photographs  attached  to  the  Enrollment  form  as  specified.  
3. DD  in  favor  of  Gate  Pathshala  Educational  Services  LLP,  payable  at  Chennai.    For  online  transfer  please  refer  website  
or  download  updated  enrollment  form  from  www.gatepathshala.com.  Send  a  Transaction  record  scan  copy  in  case  
of   Online   Transfer   or   Scan   copy   of   the   receipt   in   case   of   Cash   Deposit   at   any   AXIS   bank   branch   in   India   to  
query@gatepathshala.com .  
Account  Details:    AXIS  BANK            A/C No. 914020012764893  
IFSC CODE : UTIB0001567 BRANCH : ALANDUR, CHENNAI.
Payable to "GATE PATHSHALA EDUCATIONAL SERVICES LLP."
  
 
 
Terms  and  Conditions  
 

For  any  enquiries  Call  +91-­‐9962996817/  +91-­‐8939174202  or  send  mail  to  
info@gatepathshala.com  
 
1. Fees once paid will not be refunded under any circumstance. After paying the fees, even if a student is
eligible for any discount, the amount paid will not be refunded.

2. Gate Pathshala Educational Services LLP. Reserves the right to announce and withdraw discount
schemes at its own discretion and no claim of any kind will be entertained in this matter.

3. In case a student goes for upgrade/change of packages/change of center/change of city, etc. an extra
amount may be charged as per company policy apart from normal fees for the packages.

4. Gate Pathshala Educational Services LLP reserves the right to change the schedule and timings of
classes and tests at its own discretion.

5. Gate Pathshala Educational Services LLP reserves the right to change the date of issue of study
material and will not be liable for any delays in the material or test papers reaching a student.

6. While utmost care is taken to provide correct and up to date information, Gate Pathshala Educational
Services LLP does not guarantee the accuracy, completeness and timely availability of the information
provided and accepts no responsibility or liability for any error or omission in any information provided.

7. Gate Pathshala Educational Services LLP reserves the right to cancel a center and transfer the center
students to another center in the same city, in case of FFIC.

8. The study material, test material etc. are exclusive copyright of Gate Pathshala Educational Services
LLP, and cannot be reproduced in print or otherwise, without explicit permission of Gate Pathshala
Educational Services LLP .

9. The student has gone through the terms and conditions. By enrolling, a student agrees to abide by the
rules and regulations and company policies of Gate Pathshala Educational Services LLP as specified
on this page, and on the website www.gatepathshala.com.

I  understand  the  terms  and  conditions  and  I  agree  to  abide  by  the  terms  and  conditions  of  Gate  Pathshala  
Educational  Services  LLP.  
 
Name : _____________________________________

Signature : _____________________________________

Date : _____________________________________