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UFPL # 50472

UFPL # 50472 SIDE 1 TEST SERIES ENROLLMENT FORM IMPORTANT INSTRUCTION: USE ONLY BLACK BALL POINT

SIDE 1

UFPL # 50472 SIDE 1 TEST SERIES ENROLLMENT FORM IMPORTANT INSTRUCTION: USE ONLY BLACK BALL POINT

TEST SERIES ENROLLMENT FORM

IMPORTANT INSTRUCTION: USE ONLY BLACK BALL POINT PEN TO FILL UP THE FORM

APPLICATION NUMBER (To be assigned by office)

UP THE FORM APPLICATION NUMBER (To be assigned by office) ROLL NUMBER (To be assigned by

ROLL NUMBER (To be assigned by office)

assigned by office) ROLL NUMBER (To be assigned by office)   STUDENT / CANDIDATE’S NAME (IN
 

STUDENT / CANDIDATE’S NAME (IN BLOCK LETTER ONLY)

     

DATE OF BIRTH

   

QUALIFYING DEGREE

     

Branch

 

Passing Year

%

   
                               
 
                               
 
                               
 
                               
 
                               
 
                               
 
                               
 
                               
 
                               
 
                               
 
                               
         
                               
 
                               
 
                               
 
                               
   
                               
 
                               

A

A

A

A A

A A

A A

A A

A

A A

A A

A A

A A

A A

A

0 0

0 0

0 0

 

0 CE

 

0 0

0 0

0

0

B

B

B

B B

B B

B B

B B

B

B B

B B

B B

B B

B B

B

1 1

1 1

1 1

 

1 ME

   

1 1

1 1

1

1

C

C

C

C C

C C

C C

C C

C

C C

C C

C C

C C

C C

C

2 2

2 2

2 2

 

2 EE

 

2 2

2 2

2

2

D

D

D

D D

D D

D D

D D

D

D D

D D

D D

D D

D D

D

3 3

3 3

3 3

 

3 EC

 

3 3

3 3

3

3

E

E

E

E E

E E

E E

E E

E

E E

E E

E E

E E

E E

E

4 4

4 4

4 4

 

4 CS/IT

 

4 4

4 4

4

4

F

F

F

F F

F F

F F

F F

F

F F

F F

F F

F F

F F

F

5 5

5 5

5 5

 

5 Others

5 5

5 5

5

5

G

G

G

G G

G G

G G

G G

G

G G

G G

G G

G G

G G

G

6 6

6 6

6 6

 

6 6

6 6

6 6

6

H

H

H

H H

H H

H H

H H

H

H H

H H

H H

H H

H H

H

7 7

7 7

7 7

 

7 7

7 7

7 7

7

I

I

I

I I

I I

I I

I I

I

I I

I I

I I

I I

I I

I

8 8

8 8

8 8

 

8 8

8 8

8 8

8

J

J

J

J J

J J

J J

J J

J

J J

J J

J J

J J

J J

J

9 9

9 9

9 9

 

9 9

9 9

9 9

9

K

K

K

K K

K K

K K

K K

K

K K

K K

K K

K K

K K

K

 

L

L

L

L L

L L

L L

L L

L

L L

L L

L L

L L

L L

L

   

FATHER’S OCCUPATION

   

EXAM CODE

 

M

M

M

M M

M M

M M

M M

M

M M

M M

M M

M M

M M

M

 

0

Govt. Employee Class 4

   

0

GATE Test Series

 

N

N

N

N N

N N

N N

N N

N

N N

N N

N N

N N

N N

N

 

1

Govt. Employee Class 3

   

1

IES Test Series

 

O

O

O

O O

O O

O O

O O

O

O O

O O

O O

O O

O O

O

 

2

Govt. Employee Class 2

   

2

IES & GATE Test Series

P

P

P

P P

P P

P P

P P

P

P P

P P

P P

P P

P P

P

 

3

Govt. Employee Class 1

   

3

Others

 

Q

Q

Q

Q Q

Q Q

Q Q

Q Q

Q

Q Q

Q Q

Q Q

Q Q

Q Q

Q

 

4

Private Job

   

R

R

R

R R

R R

R R

R R

R

R R

R R

R R

R R

R R

R

 

5

Doctor

     

COURSE

 

S

S

S

S S

S S

S S

S S

S

S S

S S

S S

S S

S S

S

 

6

Business

   

0

Classroom Test Series

T

T

T

T T

T T

T T

T T

T

T T

T T

T T

T T

T T

T

 

7

Farming

   

1

Postal Test Series

 

U

U

U

U U

U U

U U

U U

U

U U

U U

U U

U U

U U

U

 

8

Teaching

   

2

Online Test Series

 
 

Others

   

V

V

V

V V

V V

V V

V V

V

V V

V V

V V

V V

V V

V

 

9

   

CATEGORIES

 

W

W

W

W W

W W

W W

W W

W

W W

W W

W W

W W

W W

W

   

SEX

     

X

X

X

X X

X X

X X

X X

X

X X

X X

X X

X X

X X

X

   

0

General

 

Y

Y

Y

Y Y

Y Y

Y Y

Y Y

Y

Y Y

Y Y

Y Y

Y Y

Y Y

Y

     

1

OBC

 

Z

Z

Z

Z Z

Z Z

Z Z

Z Z

Z

Z Z

Z Z

Z Z

Z Z

Z Z

Z

 

0

Female

   

2

SC

 
   

3

ST

 

1

Male

   
 

MOBILE NUMBER

     

TEST CENTRE

                       

CORRESPONDENCE ADDRESS (IN CAPITAL LETTERS)

 

0

Delhi

 

0

0

0

0

 

0 0

0 0

 

0

0

Father’s

   

1

Noida

 

1

1

1

1

1 1

1 1

1

1

Father’s Designation:

   

2

Hyderabad

 
 

2

2

2

2

2 2

2 2

2

2

Father’s Contact No.:

 

3

Bhopal

 

3

3

3

3

3 3

3 3

3

3

Correspondence Address:

   

4

4

4

4

4 4

4 4

4

4

   

5

5

5

5

5 5

5 5

5

5

 

6

6

6

6

6 6

6 6

6

6

Student’s e-mail:

   

Paste Photo

7

7

7

7

7 7

7 7

7

7

of Candidate

8

8

8

8

8 8

8 8

8

8

Phone (with STD Code):

   

9

9

9

9

9 9

9 9

9

9

Pin

           
 

MADE EASY Office:

  MADE EASY Office: Delhi Hyderabad   Noida   Bhopal  

Delhi

  MADE EASY Office: Delhi Hyderabad   Noida   Bhopal  

Hyderabad

Hyderabad
 

Noida

 
  MADE EASY Office: Delhi Hyderabad   Noida   Bhopal  

Bhopal

 

Corporate Office: 44-A/1, Kalu Sarai (Sarvapriya Vihar) New Delhi-110016 | Regd. Office: 25-A, Ber Sarai, New Delhi-110016

 

Do not staple

 

Ph: 011-45124612, 26560862, 9958995830, 9810541651

|

E-mail: iesmadeeasy@yahoo.co.in

   

Noida Office: D-28, Sector-63, Noida (Uttar Pradesh); Ph: 9958995830

 

Hyderabad office: 5-1-744 Bank Street, Koti (Opp. Hotel Sitara Royal) Hyderabad-95 | Ph: 040-20032005, 0-9160002324

   

Signature of candidate

 

Wrong Method

Wrong Method Wrong Method Wrong Method Wrong Method Correct Method

Wrong Method

Wrong Method Wrong Method Wrong Method Wrong Method Correct Method

Wrong Method

Wrong Method Wrong Method Wrong Method Wrong Method Correct Method

Wrong Method

Wrong Method Wrong Method Wrong Method Wrong Method Correct Method

Correct Method

Wrong Method Wrong Method Wrong Method Wrong Method Correct Method
    Signature of candidate   Wrong Method Wrong Method Wrong Method Wrong Method Correct Method

SIDE 2

EDUCATIONAL DETAILS (IN CAPITAL LETTERS)

Branch of Engg.

Name of College & City

Passing Year

% Marks

B.

Tech

M.

Tech

PROOF OF IDENTITY (Submit self attested copy of ID proof)

(*In case of absence of proof of candidate, father’s identity/address proof can be submitted)

Passport

Election I-Card

Driving License

College I-Card

PAN Card

Others (Specify)

Driving License College I-Card PAN Card Others (Specify) Card No. Signature (for office use): Name of
Driving License College I-Card PAN Card Others (Specify) Card No. Signature (for office use): Name of

Card No.

Signature (for office use):

Name of card holder:

Checked by (for office use):

PERMANENT ADDRESS (IN CAPITAL LETTERS)

Phone (STD Code):

Pin:

DEMAND DRAFT DETAILS

DD No.

Amount

Bank Name

City

Rules & Regulations

(a)

Every student is expected to maintain discipline in and outside the classroom. In case of violation of any of the rules & regulations or discipline the institute reserves the right to disenrol any student without any refund of fee.

(b)

All students are required to bring identity card daily in the class & study matter will be given through identity card only.

(c)

MADE EASY reserves the right to make any alterations in its programmes/fees/faculty/venue of classes without any prior notice to anybody. However all the changes will be informed to the students accordingly.

(d)

The batch once allotted at the time of admission will not be changed.

(e)

Students enrolled under classroom courses will not be transferred or shifted to postal course

(f)

MADE EASY students are required to submit photocopy of their IES & GATE admit cards.

(g)

It is mandatory to attach two photographs & a copy of ID proof with the form at the time of admission. (The name and photo of candidate may be published in the list of successful candidates in current or future sessions for promotion of institute).

(h)

Candidates who will avail the facility to pay the fees in two installments will be charged Rs. 2000/- extra within 45 days of commencement of batch.

(I)

The fee will be refundable only within 5 days from announcement of batch after deducting admission charges.

(j)

The student can get his seat replaced with new student within Ist three months of the batch. Replacement charges will be Rs. 2000/-. This option can be availed by students only when refund option is not available.

UNDERTAKING

I,

I certify that the information given by me is true to the best of my knowledge and belief. I understand that if anything is found false/incorrect at any state, my candidature/admission to the course shall be cancelled without any refunds.

program of the institute.

am applying for admission in

I shall abide by all the rules and regulations of MADE EASY. Also, I will have no objection on publication of my photo by the

institute after my selection in the competitive exam and the institute (MADE EASY) will be entitled to use my photo and details for its

advertisement purpose.

I have enclosed the self-attested copy of ID/Proof/Address Proof .

Date:

Place:

Signature of the Candidate

I

guardian*

(relationship with the student) of

(Student Name) hereby declare that I have completed all the formalities on behalf of the candidate. Also I have read and understood all the terms and conditions of MADE EASY.

* If candidate is not present, then guardian can sign.

Signature