CRASH COURSE for AIEEE++, 2010 by htt39969


									    STUDENT QUESTIONNAIRE                                                                                        L I M I T E D
                                                                                                                 (FORUM FOR IIT-JEE)

                                 CRASH COURSE for AIEEE++, 2010
                                       (Also helpful for Other Engineering Entrance Exams)
                                                    (For XII studying / pass students)
(For official use only)

    Registration No.:                                                         PREFERENCE OF STUDY CENTRE
                                                                                                                      Affix your
                            TEST CENTRE OPTED                                                                       Passport Size
                                                                              __________________________             Photograph

Name of the Candidate                           :

Father’s/Guardian’s Name                        :

Address (i) Correspondence                      :


            Ph. (Res.):                                                   Contact Person:

            Ph. Off.):                                                    Contact Person:

            (ii) Permanent Address:


            Ph. (Res.):                                                   Contact Person:

            Ph. (Off.):                                                   Contact Person:

Name and Full Address of School last attended ____________________________________________________

Which other Engineering Entrance Exams do you plan to take?
IIT-JEE                           BITSAT               Others ___________________________

Test-cum -Study Centres:

Registration is open at the following FIITJEE Centres viz. Delhi                  {(South Delhi - 46106000), (Punjabi Bagh - 45634000),
Rohini (47064000), Janak Puri (45616600) & (East Delhi- 43002500)}, Amritsar (3203344), Bangalore(41135682), Bhopal (4253355),
Bokaro (325511), Bhubaneswar(9040634145),Chandigarh (3010044), Chennai {Kilpauk (42859701),Adyar (64609556)}, Hyderabad
(66464102) , Indore (4274702), Jaipur (5181883), Kolkata (30537576) , Mumbai {Andheri, Navi Mumbai & Thane (42378100 /
41581500 / 9987686970)} & Patna (3299798)

                          National Admissions Office : FIITJEE House, 29 –A , Kalu Sarai, Sarvapriya Vihar, New Delhi-110016
                                             Ph: 011- 46106000 Fax: 2651 3942
STUDENT QUESTIONNAIRE                                                                                                      L I M I T E D
                                                                                                                           (FORUM FOR IIT-JEE)

How did you come to know about our Crash Course Program? Tick/fill in the appropriate choice (s).
          a)         From present/ex- FIITJEE’ian                 (Name: _________________________ Batch:______________)
          b)         From FIITJEE’s brochure taken from __________________________________________________
          c)         From newspaper advertisement (please specify the newspaper) / From posters _______________
          d)         Other mode (Please specify) _______________________________________________________

Regarding Engineering Entrance Exam, there are some traits a candidate ought to have to a large extent, in order to
become successful.
You are your best judge, so rank yourself honestly in those traits by marking a tick ( ) in the appropriate box:

                                                                            Excellent         Good           Average        Average         Poor

          Clarity of concepts
          Ability to work hard
          Analytical ability
          Ability to strain your brain without feeling
          frustrated at lack of immediate success
          Urge for Innovative approach for solving

Fee Paid Rs. ________ in Cash / DD / Pay Order No.: ___________ dated ___________ Bank _________________

Date: _____________________                            Place: ________________
                                                                                                                      (Signature of the Student)

Admission Test Date                        :           27th March, 2010.

How to register                            :          Apply on prescribed form with two passport size colour photographs,
                                                      photocopy of last Board Exam Marksheet alongwith a demand draft /pay order
                                                      for Rs. 500/- (inclusive of service tax) in favour of “FIITJEE LIMITED – Open
                                                      Test, Aptitude Test etc. A/c” payable at New Delhi towards admission test fee. For
                                                      D/D payment details for FIITJEE centres outside Delhi Visit
                                             or refer to enclosed Annexure - H.

                                                      Admission Test registration fee can also be paid in cash in person.

Last Date to Register                      :           By post: 20th March, 2010 In person : 26th March, 2010

Note 1:   FIITJEE reserves the right to offer any study centre, other than the one opted by the student, subject to availability / constraints of seats.
Note 2:   Once admission is granted to the hostel, students will not be permitted to withdraw during the course of the academic session and no
          refund will be made during mid session.
Note 3:   Registration fee will not be refunded in any case.
Note 4:   Once a student joins the study centre offered, (irrespective of his / her choice of study centre before joining) no request for change of
          study centre will be entertained, nor will the course fee paid be refunded under any circumstances.
Note 5:   FIITJEE reserves the right to change / cancel any program, test date, eligibility criterion & course fee without prior notice.
Note 6:   The registered office of FIITJEE Limited is at New Delhi. In case of 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.

                   National Admissions Office : FIITJEE House, 29 –A , Kalu Sarai, Sarvapriya Vihar, New Delhi-110016
                                      Ph: 011- 46106000 Fax: 2651 3942

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