Admission

Admission Form

Fill this form to begin your enrolment. Our counsellors will call within 24 hours
to confirm your batch and fee plan — EMI available.

ADMISSION FORM

1Student & Guardian

2Academic & Documents

3Undertaking & Signatures

Step 1: Student & Guardian Details

Student Details

1. Course into which admission is sought

Photograph

2. Full Name of the Applicant (CAPITAL LETTERS)

3. Father's Name

4. Mother's Name

5. Father's Source of Income

6. Mother's Source of Income

7. Nationality

8. Date of Birth

9. Sex

10. Category

11. Mother Tongue

12. Religion

13. Blood Group

14. Aadhaar No.

15. Permanent Address

At / Village

Post Office

Police Station

District

State

PIN Code

Mobile Number

Telephone (if any)

Email Address

16. Local Guardian Details (if any)

Name of Local Guardian

17. Relationship

At / Village

Post Office

Police Station

District

State

PIN Code

Mobile Number

Telephone (if any)

Email Address

Guardian Photograph

Step 2: Academic Details & Documents

18. Details of Academic Career (From 10th / +2 Standard Onwards)

Sl. No.	Name of Qualifying Examination	Year	Name of Institution	University / Board	Grade	Division / Percentage	Mark Sheet
1
2
3

Required Documents

Two Photocopies of Student Photograph

Father / Mother / Local Guardian Photograph

Class 10th Mark Sheet

Class 12th Mark Sheet

Declaration by the Applicant

I want to apply for taking admission in Aadarshaa Medical Coaching Institutions, Bhubaneswar, and declare that the above particulars given by me are true to the best of my knowledge and belief. I agree to abide by all the rules and regulations of the institution.

Place

Date

Applicant Signature

Step 3: Undertaking & Parent/Guardian Declaration

I, Shri/Miss , Son/Daughter of Mr./Mrs. , residing at , do hereby undertake that I have gone through the provisions of this undertaking thoroughly and I do not have any objections to the provisions of the undertaking mentioned in the handbook of Aadarshaa meant for institute students. I received a copy of the printed handbook and declare to the effect that I shall abide by the rules and regulations framed by the Institution authority failing which disciplinary action will be taken against me.

I can never challenge the decision of the Institution authority which is final.

Signature of the Candidate:

I do herewith agree to abide by the rules & regulations of the Institution by my Son / Daughter.

Signature of the Guardian:

Signed on this day of in the month of in the year

Verified by
Institution Authority

Counter Signed
by the Institution with Seal

PhotoFull Signature of Father

PhotoFull Signature of Mother

PhotoFull Signature of Local Guardian

DECLARATION BY PARENTS/GUARDIAN

I hereby declare that this application duly filled in by me or by my son/daughter is true to the best of my knowledge and belief. I assure to provide all financial support to him/her as per the terms and conditions of the institution.