ADMISSION FORM No:
ADMISSION FORM
1. Name of the Candidate : _____________________________ AFFIX
PASSPORT SIZE
2. Father’s/ Guardian’s Name : _____________________________ PHOTOGRAPH
3. Address : _____________________________
____________________________
Telephone Number : _______________ Mobile: __________________________
e-mail : _________________________________________________
4. Date of Birth : _________________________________________________
5. Educational Qualification : _______________School/College____________________
6. I am planning to rite the entrance examination of the following institutions:
NIFT UG/PG NID UG/PG CEED B. Arch. (NATA) B. Arch (AIEEE)
Pearl Academy Shristi, Bangalore SOFT, Pune Apeejay Institute of design, Delhi
For any other course mention on the space provided____________________________________________
7. I came to know about TAKSHSHILA from:
Newpapers Banners Internet Others
8. You want to join TAKSHSHILA for
Class room coaching Postal coaching
I, ________________________ declare that above information given by me is correct and I will follow the rules
and regulation of the institution. The authority can take disciplinary action in case of misconduct. Fees paid
cannot be refunded under any circumstances.
Date :
Place : Parents/ Guardian Signature Students Signature
FOR OFFICE USE ONLY
Received on _________________________, Registration No. ______________________________________________
Cash/ Bank Draft for Rs. ______________, Name of the Bank and Branch __________________________________
Receipt No. __________________________, Date: ___________________________.
Batch Timings: __________________________________________.
Courses Fees: Rs.
Authorized Signatory