Registration Form for UGC NET Correspondence Courses @ Astral Education Acdemy
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ASTRAL EDUCATION ACADEMY (A venture by Astral Heights Group) www.UgcNetCoaching.com 1. Your Name 2. Date of Birth 3. Phone No. (with STD Code) 4. E-Mail Address............................................................................................. 5. Qualification Details : 6. Your Present Occupation................................................. 7. Father’s/Husbands Name............................ 8. Correspondence Address (Please mention the address on which you want the material to be sent, also mention landmarks so that courier should reach you without any inconvenience) ......................................................................................................................................................................... ......................................................................................................................................................................... ......................................................................................................................................................................... ...................................................................................................................Ph.................................................. 9. Permanent Address ......................................................................................................................................................................... ......................................................................................................................................................................... ......................................................................................................................................................................... ...................................................................................................................Ph.................................................. (Mob.) D D M M Y Y Form No._____________ (To be filled by us) Affix a recent colored passport size photograph here. Do not staple or pin Do not write anything on photograph REGISTRATION FORM FOR UGC NET CORRESPONDENCE COURSES PLEASE FILL COMPLETE FORM IN CAPITAL LETTERS DEGREE / COURSE (SPECIALISATION & DURATION ALSO) UNIVERSITY / BOARD PASSING YEAR PG UG XII Any Other % AGE/ CGPA/ GRADE 10. Expected Net Exam Appearing Date 11. Exam Centre/Code 12. Net Roll No. (if already applied) 16. Course Type : Normal Correspondence Test Series Fast Forward 17. Source of Information : Google / Online Ad / Face Book / Pamphlet / Hording / Friend / Other ................................... .......................................... Signature of the Student Please fill in Payment Deatils (Please attach Payment Receipts) FEES DEPOSITED....................................... TRANSACTIONS NUMBER.......................... MODE OF PAYMENT ................................ BANK BRANCH...................................... PAYMENT DATE.......................... .......................................... Name of the Student .......................................... Date 13. Previous Net Result (if any) ........................................................ DECLARATION : I have read and understood all the terms & conditions written in this form as well as in the website, email, brochure, prospectus, pamphlets etc. I also know that the fees paid by me will not be refunded / transferred/ adjusted under any circumstances. By signing, I allow you to use my information/ Photograph for your advertisement purpose on any of the medium used by you. I also know that I do not have any rights to reproduce / resell / Xerox / Photostat / Scan / or any other way or give away to study material/ prints notes / class notes of the institute and they are solely the property of Astral Education Academy and its owner company. I hereby declare that I will abide to all said terms & conditions, in any case I am found guilty of it, my candidature can be cancelled immediately and fee paid by me will be fully forfeited as well as I can be legally penalized also & will be responsible to pay all the losses occurred due to my irresponsible activity. 14. Subject Code/Name............................................................. 15. Specialization / Elective.......................................................
Transcript of Registration Form for UGC NET Correspondence Courses @ Astral Education Acdemy
ASTRAL EDUCATION ACADEMY(A venture by Astral Heights Group) www.UgcNetCoaching.com
1. Your Name
2. Date of Birth
3. Phone No. (with STD Code)
4. E-Mail Address.............................................................................................
5. Qualification Details :
6. Your Present Occupation................................................. 7. Father’s/Husbands Name............................
8. Correspondence Address (Please mention the address on which you want the material to be sent,
also mention landmarks so that courier should reach you without any inconvenience)
.........................................................................................................................................................................
.........................................................................................................................................................................
.........................................................................................................................................................................
...................................................................................................................Ph..................................................
9. Permanent Address
.........................................................................................................................................................................
.........................................................................................................................................................................
.........................................................................................................................................................................
...................................................................................................................Ph..................................................
(Mob.)
D D M M Y Y
Form No._____________(To be filled by us)
Affix a recent coloredpassport size
photograph here.
Do not staple or pin
Do not write anything on photograph
REGISTRATION FORM FOR UGC NET CORRESPONDENCE COURSES
PLEASE FILL COMPLETE FORM IN CAPITAL LETTERS
DEGREE / COURSE(SPECIALISATION & DURATION ALSO)
UNIVERSITY / BOARDPASSING
YEAR
PG
UG
XII
Any Other
% AGE/ CGPA/GRADE
10. Expected Net Exam Appearing Date 11. Exam Centre/Code
12. Net Roll No. (if already applied)
16. Course Type : Normal Correspondence Test Series Fast Forward
17. Source of Information : Google / Online Ad / Face Book / Pamphlet / Hording / Friend / Other...................................
..........................................Signature of the Student
Please fill in Payment Deatils (Please attach Payment Receipts)
FEES DEPOSITED.......................................
TRANSACTIONS NUMBER..........................
MODE OF PAYMENT................................
BANK BRANCH......................................
PAYMENT DATE..........................
..........................................Name of the Student
..........................................Date
13. Previous Net Result (if any)
........................................................
DECLARATION : I have read and understood all the terms & conditions written in this form as well as in the website, email, brochure, prospectus, pamphlets
etc. I also know that the fees paid by me will not be refunded / transferred/ adjusted under any circumstances. By signing, I allow you to use my information/ Photograph for your advertisement purpose on any of the medium used by you. I also know that I do not have any rights to reproduce / resell / Xerox / Photostat / Scan / or any other way or give away to study material/ prints notes / class notes of the institute and they are solely the property of Astral Education Academy and its owner company. I hereby declare that I will abide to all said terms & conditions, in any case I am found guilty of it, my candidature can be cancelled immediately and fee paid by me will be fully forfeited as well as I can be legally penalized also & will be responsible to pay all the losses occurred due to my irresponsible activity.
14. Subject Code/Name.............................................................
15. Specialization / Elective.......................................................
