THEOPHRAS ACADEMY

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ENQUIRY FORM
Enquiry No:
PHOTOGRAPH

COMPULSORY DETAILS

Name (in Capital):

Father/Guardian Name:):

Contact no: Gender: M F

Date of Birth:
Highest Qualifications: 10th 12th Graduation PG

COMMUNICATION ADDRESS

Address Line1:
Address Line2:
City: Pin code No:
Mobile No: Tel. No:

Email:

OTHER DETAILS

Occupation: Student Employed Self Employed

If Employed,
Employer Name:
Designation:

Functional Area:

Work Experience: In Years

Salary(INR): <10,000 10,000 – 15,000 15,000-20,000 >20,000

Does your school/college’s curriculum include Tally, CA, CMA & Python as an additional subjects? Yes No

Additional skills/ Training: ________________________________________________________________________________________________ _____________

 PLEASE INDICATE THE COURSE / CERTIFICATION INTERESTED IN
Tally Certification Professional Coaching Computer Coaching Other Coaching

Tally Essential Level 1 CA Foundation Computer Application Spoken English

Tally Essential Level 2 CA Intermediate PYTHON Accounts Tuition

Tally Essential Level 3 CMA Foundation C/C++ Other tuition

Tally Essential Comprehensive CMA Intermediate Excel Advanced Other :__________________

Tally Professional

HOW DID YOU COME TO NNOW ABOUT OUR CENTRE

Social Media College Help Desk/Kiosk Hoardings

News paper/ Classified Seminar Banner/ Poster/

Pamphlet/Leaflet
TV / Radio Tele Calling
Mailer Other :______________________

Please refer 2 of your friends who would be interested in joining any of our courses

Name :_______________________________ Contact Number :_______________________________

Name :_______________________________ Contact Number :_______________________________

I hereby confirm that the above information is all correct and true to my knowledge.

Candidate’s signature:_______________________________

For Office Use Only

THEOPHRAS ACADEMY
No:23,Rajaram salai,
Near E-seva Maiyyam,
K K Nagar,
Trichy-620021. Tamilnadu.

Date: _______________________________

Counselor’s signature:_______________________________