ADMISSION FORM FOR CLASSROOM/HYBRID/DIGITAL COURSE

☑ I understand and agree that the personal information will be collected by Aakash Educational Services
Limited (“Company”) while submitting the admission form and the personal information may be used or
stored by the Company as mentioned under the Company’s Privacy Policy. I have read and agree to the
Company’s Privacy Policy in it’s entirety

Form Filled by Parent and I agree that at the time of filling the admission form my age is 18 or above.

PSID: Branch
00013092210 Tirunelveli Branch

Stream: Term
Medical 2426

Course Name Batch Option

2 Year Integrated Classroom Course Weekdays-Morning
for NEET EDUSTAR INTERNATIONAL
SCHOOL - 720598

Personal Detail

Student Name: Yojana R

Date of Birth 06/07/2009
Gender Male
Category
Student Email ID : yojana111111@gmail.com
Primary Mobile No. 9361839747
Secondary Mobile No. : 8838026845
Father’s Name : Ravi
Mother's Name Karpagam
Parent's/Guardian's Occupation : Others
Nationality : India
Blood Group : A+

Address Details

Correspondence Address

Address: 1/156-2B, EB Colony, Reserve line, Sivakasi

Pincode: 626123
State: Tamil Nadu
City : Virudhunagar
Phone No :
Parent's Email ID :

Permanent Address

Address: 1/156-2B, EB Colony, Reserve line, Sivakasi

Pincode: 626123
State: Tamil Nadu
City: Virudhunagar
Phone No:

Education Detail

Class Studying: 11
Exam Board: CBSE
School State: Tamil Nadu
School City: Tuticorin
School Name: EDUSTAR INTERNATIONAL SCHOOL
Marks Obtained in last class %: %
Grades Obtained in last class: Math :

Science :

Original marksheet of the last board or equivalent exam

Copy of Identity Card issued by Aakash

Date: 15-05-2024
☑ I hereby authorize the Company and/or its service provider(s) to reach out with transactional/promotional/
other information on my coordinates (whatsapp/ email/ mobile number)
☑ I hereby acknowledge that the information and/or documents provided by me are correct and true. In case of
any discrepancies in the information provided by me, Company shall reserve the right to cancel/reject my
application form
☑ I hereby read, understood and agree the terms and conditions of the Company.

The details of the admission form has been verified by the customer through OTP authentication
on mobile number 9361839747 and 8838026845 at 15-05-2024 17:42:21 at 112.133.219.147