REGISTRATION FORM

Maharashtra Science Talent Search Exam (MSTSE) - 2010

for Paste your recent
passport size
Aspirants of IIT-JEE, 2013 color photograph
(Students presently studying in Class X in Maharashtra State) here and attach
one additional
photograph with
Registration No. : - this Application
(for Official use only)
Form for the Hall
Ticket
Please fill this form with a black / blue pen in Block Letters only.

1. (a) If you are already enrolled in any FIITJEE Program, please provide your Enrollment Number _____________________________
(b) If you are not enrolled but appeared in any FIITJEE test in last one year, please provide your Registration Number
_______________________________ / Mobile / Tel. No. provided at the time of Registration______________________________

2. Details about MSTSE (for Registration Centre, Study Centre, Test Centre Code & Program Code, please refer to point no. 7, 8 & 9)

(a) MSTSE Test Date 2 3 1 0 2 0 1 0 (b) Registration Centre Code

(c) Study Centre Code (d) Test Centre Code

(e) Program Code

3. Preference of Language of Test Paper {please tick (√)} English

… Marathi
…
4. Details about the Student

(a) Name of the Student ________________________________________________ Gender (√): Male

… Female …
(b) Father’s Name ___________________________________________________
(c) Date of Birth (DD/MM/YYYY)
(d) Aggregate Marks secured in Last School Exam (%) __________________

5. Details about the School Presently Studying in

(a) School Name and Address _________________________________________________________________________________

(b) Board (School is affiliated to) _______________________________ (c) Postal Pin Code of the School
………………
6. Communication Details

(a) Mobile No (10 Digits) ………………………… (b) e-mail id ___________________________________

(c) Correspondence Address _________________________________________________________________________________

_________________________________________________________________________________
Pin Code
……………… State ___________________ Tel No__________________

(d) Permanent Address _________________________________________________________________________________

_________________________________________________________________________________
Pin Code
……………… State ___________________ Tel No__________________

Declaration by the Student / Parent / Guardian

• I have read the Terms & Conditions printed in this Form and agree to abide by the same.
• I have also cross verified the Codes filled in above and I understand if an error occurs in the registration due to wrong codes it will
not be corrected by FIITJEE.
• The Test Date, Test Centre, Program Code etc. can not be changed once registered.
• I authorize FIITJEE to call me and send me information by sms, e-mail, post on the above mentioned communication details.

Date : __________________ Signature of the Student / Parent / Guardian

7. Registration / Study Centre Codes {to be filled in point no. 2 (b) & 2 (c) of this Registration Form} :

CENTRE CODE CENTRE CODE

Mumbai (Andheri) 42 Mumbai (Navi Mumbai) 45
Mumbai (Chembur) 43 Mumbai (Thane) 40
Mumbai (Dadar) 41 Nagpur 49
Mumbai (Kandivali) 44 Pune 39

8. Test Centre Codes {to be filled in point no. 2 (d) of this Registration Form} :

Test Centre Code

Mumbai (Chembur) – St. Anthony High School, St. Anthony Road, Behind OLPS Church School, Chembur 432
Mumbai (Kandivali) - Thakur Vidya Mandir High School & Junior College, Thakur Complex, Kandivali (E) 440
Mumbai (Navi Mumbai) - FIITJEE Ltd., B - 500, Second Floor, Vashi Plaza, Plot No. 80 - 81, Sector - 17, Vashi 450

Mumbai (Sion) - D.S.High School, Sindhi Colony (Sion Bus Depot), Sion West 412

Mumbai (Thane) - New English School, Ram Maruti Road, Thane (West) 402
Mumbai (Andheri) – Holy Family High School, Mahakali Caves Road, Opp. Nelco, Chakala Road, Andheri (E) 424
Nagpur - CP & Berar College, Tulsibag Mahal 117
Pune - FIITJEE Ltd., 3rd Floor, A – Wing, Vega Centre, above Airtel Office, Swargate, Shankar Sheth Road 390
Aurangabad - S. B. High School, Aurangpura, 914
Jalgaon – For Venue, please contact FIITJEE Mumbai (Dadar) Centre.
Nasik - For Venue, please contact FIITJEE Mumbai (Dadar) Centre.
Tarapur - For Venue, please contact FIITJEE Mumbai (Dadar) Centre.

9. Program Name & its Codes {to be filled in point no. 2 (e) of this Registration Form} :

Program
Program Name
Code
Two Year Classroom Program for IIT-JEE, 2013 – Regular Week Contact Classes# 1151
#
Two Year Classroom Program for IIT-JEE, 2013 – Weekend Contact Classes 1152
#
Two Year Classroom Program for IIT-JEE, 2013 – Special Weekend Contact Classes 1154
Pinnacle - Two Year Integrated School Program for IIT-JEE, 2013 1110

# Not all program options are available at all study centre locations. Kindly get in touch with preferred study centre for more details.

How to Register : Fill in your complete details in the Registration Form mentioning test centre, preference of
language of test paper, study centre & program alongwith the photocopy of last school exam
marksheet / school identity card, two passport size colour photographs and submit it to the
nearest FIITJEE centre.
Registration Form can also be downloaded from http://mstse.fiitjee.com.

You can also send the Registration Form by post / courier to FIITJEE Mumbai (Thane) / Nagpur / Pune Centre. Last Date
to receive completed Registration Form by post is 16th October, 2010

Last Date to Register : Wednesday, 20th October, 2010 (in person)

Registration Fee : Nil

I hereby declare that the information furnished on this Registration Form is correct to the best of my knowledge and
belief.

Place : ____________________
___________________________________
Date : ____________________
(Signature of the Student / Parent / Guardian)

Registration Form Checked by:___________________________________ Signature: _______________________ Date: _________________

(for office use only)
MSTSE – 2010 (Terms and Conditions)

Note 1 : A Total of 350 students - 250 for FIITJEE Centres in Greater Mumbai (Dadar, Kandivali, Chembur, Andheri, Navi
Mumbai & Thane), 50 for FIITJEE Nagpur Centre & 50 for FIITJEE Pune Centre - will be selected through
MSTSE-2010 subject to students scoring above a minimum cut-off marks in each subject. Based on the total
marks scored in the exam a common merit list will be prepared. Those students who do not clear the total cut-off
marks and individual subject cut-off marks in the Exam will not qualify for the final merit list.

Note 2 : The final discretion will remain with FIITJEE management and this decision will be final and binding on the
candidate.

Note 3 : Fee waivers for FIITJEE programs & Hostel Fee concessions are valid for student joining Two Year Classroom
Program for IIT-JEE, 2013 OR PINNACLE - Two Year Integrated School Program for IIT-JEE, 2013 till 20th
November, 2010 at FIITJEE Greater Mumbai, Nagpur or Pune centre only.

Note 4 : Hostel fee concessions are valid only for FIITJEE’s associate hostels / lodging and boarding facilities (for male
students only) made available through FIITJEE, subject to the student joining that particular hostel and availability
of seats. The Hostel Fee concessions are valid for the above mentioned programs only. The concession will be
given monthly between April, 2011 to March, 2013 for joining Two Year School / Classroom Program and only for
the duration of school / classroom program. The hostel fee concessions will be paid directly to the hostel owner
by FIITJEE. Hostel fee concessions is for accommodation only. Food, transportation & other self expenses are to
be borne by the students. Hostel facility is available at select FIITJEE Centres only.

Note 5 : FIITJEE students already enrolled in Classroom Program for IIT-JEE, 2013 can appear in Maharashtra Science
Talent Search Exam to find about their current level of preparation and their projected Rank in IIT-JEE / Other
Competitive Entrance Examinations. We are already committed to these students in giving our complete support
at any point of their preparations. Since these students are already getting all benefits and additional inputs
through our classroom programs, Maharashtra Science Talent Search Exam is only for giving the feedback to
their preparation and no Fee Waivers / Concessions of any kind will be offered to such students. However,
FIITJEE students will be entitled for rewards as per their performance in IIT-JEE Examination (for details refer
page no. 14 of MSTSE Brochure).

Note 6 : Students presently in class X and enrolled at FIITJEE in ASCENT Program can register themselves as a FIITJEE
student and are entitled for benefits (Fee Waivers) of Maharashtra Science Talent Search Exam only on joining
relevant program for IIT-JEE, 2013 by 20th November, 2010.

Note 7 : The registered office of FIITJEE Limited is at New Delhi. In case of any dispute, students / parents are subject to
the exclusive jurisdiction of appropriate courts in Delhi / New Delhi only. All disputes shall be referred to the Sole
Arbitrator appointed by the Management of FIITJEE Ltd. The decision of the arbitrator shall be final & binding.
The arbitrator so appointed shall not be incapacitated for reasons of their being the employee of FIITJEE Ltd. or
its sister concern and for reasons of having any prior linkage with the company. The seat of arbitration will be
Delhi. All the parties - student / parents / guardian & FIITJEE agree that they shall not commence or maintain any
action in a court of law relating to MSTSE, subsequent enrollment & studies at FIITJEE except for enforcement of
the arbitral award. All parties waive any right to appeal. This is needed for speedy redressal of issues & all parties
agree to this.

General Terms and Conditions

Note : No student can appear in FIITJEE admission test (including Maharashtra Science Talent Search Exam) more
than twice in one academic year. If any student appears for the third time his / her application will be
disqualified before the admission test or even if identified after taking admission his / her enrolment can be
cancelled and fee deposited will be forfeited. FIITJEE can also take legal action against such student and his /
her guardian.

National Admissions Office : FIITJEE House, 29-A, Kalu Sarai, Sarvapriya Vihar, New Delhi – 110016
Ph: 011 - 46106000 / 10 / 13 / 15 All India Toll Free No. : 1800 11 4242 Fax: 011 - 26513942 Website : www.fiitjee.com