Respected Sir,

I want to take admission in your esteemed Institute for the Distance Learning Course marked (3) in the box. My particulars are given below:

Affix yourrecent passport

size colour photograph

here.

School / College Name & Address:

Father’s/Guardian’s Name*:

Occupation of Father / Guardian:

Occupation of Mother:

Category* (GEN / OBC / SC / ST / PH): Date of Birth*: DD MM Y YYY Gender (M/F):

Address:

City:

State: PIN:

E-Mail ID*:

Personal Details

First Name*:

Last Name*:

Mother’s Name*:

(It is compulsory to fill the form clearly in CAPITAL LETTERS only) Mandatory fields are marked with asterisk (*)

Phone (Residence): S T D Phone (Office): S T D#

Mobile Parents: Student: SMS:*

Education Details

How did you come to know about Aakash? NewspaperPromotions Team Radio/TVTeachers Friends/Relatives WebsiteEx-Aakashians

Sincerely,

(Signature of the Student)*

If Ex-Aakashian, please mention your Aakash PSID: Section:

Exam. Board: (CBSE | ICSE/ISC | HS | Other) (Attach a Self-attested Photocopy of Your Original Marksheet)

Place:#Kindly give such number which is not in National Customer Preference Registry (NCPR) mode.

Correspondence Address

Date: DD MM Y YYY

Course Type : AIATS Question Bank

CJP+ Test Series

Current Class : XII studying XII passed (Please (3) in the relevant box)X passed / XI studyingVIII IX X

Grades / Marks Obtained: ......... % XII Board (PCM/PCB - Aggregate)and / or% (VII / VIII / IX School Exam & X Board (Science & Maths - Aggregate)

Year 20 __ __ to 20 __ __

CTP - Comprehensive Test Package Plus, CJP+ - Comprehensive Joint Package Plus, AIATS - All India Aakash Test Series

10% 15% 20% 25% 30%Eligibility for Scholarship: Others: 45%

Study Package Merit Package

Classic PackageWithout SD Card With SD Card

DLP iTutor

(To be filled by office only)

PS-ID / Registration No. ..................................... Date: DD MM Y YYY

COURSE APPLIED FOR: (Please mark (3) against the course you wish to apply)

Course Duration : 1 Year 2 Years 3 Years 4 Years

Medical EngineeringFoundation

VIII Studying

IX Studying

X Studying

XI Studying

XII Studying

XII Passed

XI Studying

XII Studying

XII Passed

If applied Offline AIATS, Please write

Centre Name & Code:

HindiEnglish

CTP

Medium of Study Package Mode of AIATS: Offline:(English only)Online or

Note : 4 Years courses applicable for class IX, 3 Years courses applicable for class X

ADMISSION FORM FOR DISTANCE LEARNING

Course Code(6 Digit ERP Code)

Course Name

Note: It is mandatory for student & parents to sign at the appropriate places failing which admission form will not be processed and will not be considered.

For Office Use Only

Terms & Conditions

I have read the Terms & Conditions of AESL and various policies of the Company as mentioned in the prospectus & promise to abide by the same.

(Signature of the Parents/Guardian*) (Signature of the Student*)

Category of Scholarship Category-A Category-B

PS-ID/Registration No.: Office Receipt No.: Receipt Date:

Admission Place: Centre

Prov. Receipt No.

(Please tick the relevant box.)

*ChecklistOne recent passport size colour Photograph (latest).

Photocopy of self-attested mark-sheet of the last qualifying Exam VII / VIII / IX / X or XII as applicable.

DD in favour of ‘Aakash Institute’ payable at the nearest Centre.

Centre Code, Centre Name and Medium of AIATS should be properly mentioned on the Admission Form.

If you are an Ex-Aakashian, attach a photocopy of Identity Card issued by Aakash or PS ID along with the Admission Form.

Attach proof of Scholarship along with the Admission Form to avail concession.

Provide E-Mail ID & Mobile no. for sending of information / SMS.

It is compulsory for Parents / Guardian and student to sign on the Terms & Conditions.

Date:Demand Draft / Cheque* No.: Drawn on:Amount ( ):

AA Code:Employee ID:

Branch Head (Name): Branch Head (Signature):

6. Institute reserves the right to use the single/group photograph(s) for publicity in

case the student(s) secures position/rank or succeeds in Medical / Engineering

Entrance Exams & Scholarship/Olympiad & Other Competitive Exams.

3. The duly filled in scanned Admission Form should be sent to or care.dlp@aesl.in

submitted to nearest akash centre.A

20. The Examination Centre of any place can be changed as per the requirement

/need of the company without any prior notice to the students / parents.

5. It is compulsory for students to paste a recent passport size colour photograph in

the space provided and also staple two extra colour photographs with the

Admission Form.

16. Any change in address or phone numbers should be notified to the DLP Division

15 days prior from the next dispatch date without any delay through a written

application or email at care.dlp@aesl.in otherwise rest of the dispatches will also

be stopped.

14. If the dispatch is returned to us due to change of address / door locked / non-

availability of addressee, the courier / postage charges of ̀ 500/- will be charged

for sending the dispatch again. If the said amount is not paid by the student then

rest of the dispatches will be hold.

23. In case of any dispute or difference between you and Institute regarding the

interpretation of these terms and conditions, non-payment of any claim or any

dispute arising out of or in pursuant to these terms and conditions, the same shall

be referred to sole Arbitrator who shall be appointed by Managing Director of M/s

Aakash Educational Services Limited. The proceedings shall be conducted at

New Delhi under the provisions of Arbitration & Conciliation Act and the Courts at

Delhi only shall have the jurisdiction over the matter and/or for enforcement as the

case may be. If an Arbitrator to whom the matter is referred refuses to act or for

any reason, does not enter the reference or after entering into the reference

proceedings are abandoned or kept in abeyance or not proceeded with, it shall be

lawful for the Managing Director of M/s Aakash Educational Services Limited to

appoint another person to act as an Arbitrator in the manner aforesaid. Such

person shall be entitled to proceed with reference from the stage at which it was

left by his predecessor, if both the parties consent to this effect, failing which the

Arbitrator will be entitled to proceed de novo.

9. Refund & Transfer Policy will be applicable as per prospectus.

13. If the study material provided to the student is lost / misplaced once delivered at

his/her correspondence address, a duplicate book can be obtained against the

payment of ` 300/- per book (including GST), through DD / Cheque /Online /

Card.

4. It is compulsory to attach a self-attested photocopy of the mark-sheet of the last

qualifying Exam VII / VIII / IX / X or XII as applicable.

11. The responsibility of getting admission form forwarded to the examining body is

that of the student himself/herself or that of the Parents / Guardian.

7. Students enrolled in Aakash Institute's Distance Learning Course will have to

provide photocopy of Admit Card of Medical (NEET) Entrance Exam / JEE (Main

& Advanced) Entrance Exams / Scholarships or Olympiads and other Exams as

soon as they receive their admit cards from the examining body.

18. If at any point of time, the Central Govt. further increases GST, (existing rate of

GST is 18%) the extra amount of GST will be borne by the students from the date

of enforcement of the act by the Govt.

2 If there is any pendency in admission form, after 1st dispatch further dispatch will

be on hold.

21. If any student fails to receive the study material within 15 days from the date of

dispatch, kindly inform the DLP Division telephonically at 7428330111 or write

us at : care.dlp@aesl.in

10. It is for the student to see whether he / she is eligible for NEET Entrance Exams /

JEE (Main & Advanced) Entrance Exam / Scholarships or Olympiads exams or

not. The Institute does not hold itself responsible if a student's admission form

cannot be forwarded or is rejected by the examination body on any ground

whatsoever. Such a student cannot claim a refund of the whole or any part of the

fee he/she has paid to the Institute.

12. In case of school Tie-up, School Principal / Signing Authority / Parents will be

treated as Guardian.

1. Incomplete Forms shall not be considered under any circumstances.

8. The dispatch of books shall be made against clearance of payment and

completion of enrolment documents.

15. If the SD card is lost / misplaced once deliever, then a student can ask for new

content SD card for INR 1500/- through DD / online mode / cheque.

17. For the change of AIATS Mode and Centre, ̀ 500/- (for each change) will also be

charged from DLP enrolled students. Mode and Centre can be changed once in a

session.

19. Aakash Institute reserves the right to make any alteration in its programs / venue /

timing without any prior notice. The decision of the Director will be final and

binding on the students as well as the parents.

22. Do not Disturb (DND): AESL may also contact the user through SMS, WhatsApp,

email and call to give notifications on various important updates. Therefore, User

holds AESL non liable for any liabilities including financial penalties, damages,

expenses in case the users mobile number is registered with Do not Disturb

(DND) database.