MILLANIAL EDUCATION

Enrolment Form

NAME IN FULL: …………………………………………………………………………………………………….

ADDRESS : ……………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………….

TEL: ……………………..; ……………………… N.I.C NO: ……………………………… NIC PHOTO COPY:

( )

MODULE: GENERAL / ACADEMIC REQUIRED BAND SCORE: …………………………………………..

TENTATIVE DATE OF EXAMINATION: ……………………………………………………………………………...

DATE OF COMMENCEMENT :………………………………………………………………………………………….

(Parents/ Guardians Name & Contact No:)………………………………

…………………………………………………………………………………………………….

TERMS & CONDITIONS; AMOUNT: Rs:…………………………….

(*) BALANCE PAYMENTS SHOULD BE COMPLETED WITHIN 1 WEEK FROM COMMENCEMENT.

1) I do hereby understand that any fees paid in respect of IELTS classes, in full or in part thereof, shall not be
refundable under any circumstances nor transferable to another course/for another student, in this
institution.
2) In case of absence of over 2 months by the student, an extension fee of Rs.2,000/- will be charged, in addition
to the fees paid.

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SIGNATURE DATE

Authorised British Council IELTS Registration Centre