F5495610OMR Testseries

SIDE 1
TEST SERIES ENROLLMENT FORM

IMPORTANT INSTRUCTION: USE ONLY BLACK BALL POINT PEN TO FILL UP THE FORM ROLL NUMBER (To be assigned by office) APPLICATION NUMBER (To be assigned by office)
STUDENT / CANDIDATES NAME (IN BLOCK LETTER ONLY)
DATE OF BIRTH
Date Month Year
QUALIFYING DEGREE
Degree Passing Year %
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
A B C D E F G H I J K L M N O P Q R S T U V
W
A B C D E F G H
I
A B C D E
F
A B C D E F G H I J K L M N O P Q R S T
U
A B C D E F G H I J K L
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
CE ME
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
EE EC CS/IT Others
G H I J K L M N O P Q R S T U V W X Y Z
J K L M N O P Q R S T U V W X Y Z
FATHERS OCCUPATION
0
EXAM CODE
0 1 2 3
Govt. Employee Class 4 Govt. Employee Class 3 Govt. Employee Class 2 Govt. Employee Class 1 Private Job Doctor Business Farming Teaching Others
M 1 N 2 O 3 P 4 Q 5 R 6 S 7 T 8 U 9 V W X Y Z 0 1
GATE Test Series IES Test Series IES & GATE Test Series Others
CATEGORIES
0 1 2 3
General OBC SC ST
V W X Y Z
TEST CENTRE SEX

Female Male
0 1 2 3 4 5
Delhi Hyderabad Noida Jaipur Bhopal Other
X Y Z
MOBILE NUMBER
CORRESPONDENCE ADDRESS (IN CAPITAL LETTERS)

0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
Fathers Name:. ...................................................................... Fathers Designation:............................................................... Fathers Contact No.:............................................................... Address: ................................................................................. ................................................................................................ e-mail: ................................................................................... Phone (STD Code): ........................................ Pin
Signature of candidate
Photo of Candidate
MADE EASY
Noida Office: D-28, Sector-63, Noida (Uttar Pradesh); Ph: 9958995830
Branches:
Delhi
Hyderabad
Noida
Corporate Office: 44-A/1, Kalu Sarai (Sarvapriya Vihar) New Delhi-110016 | Regd. Office: 25-A, Ber Sarai, New Delhi-110016 Ph: 011-45124612, 26560862, 9958995830, 9810541651 | E-mail: iesmadeeasy@yahoo.co.in Hyderabad office: 5-1-744 Bank Street, Koti (Above Khadi Bhavan, Opp. Hotel Sitara Royal) Hyderabad-95 | Ph: 040-20032005, 0-9160002324
Wrong Method
Wrong Method
Wrong Method
Wrong Method
Correct Method
SIDE 2
EDUCATIONAL DETAILS (IN CAPITAL LETTERS)

Branch of Engg. B. Tech M. Tech Name of College & City Passing Year % Marks
PROOF OF IDENTITY (Submit one of the following proofs)

(*In case of absence of proof of candidate, fathers identity/address proof can be submitted)
Passport
Election I-Card
Driving License
College I-Card
PAN Card
Others (Specify)
Name of card holder: Checked by (for office use):
Card No. Signature (for office use):
PERMANENT ADDRESS (IN CAPITAL LETTERS)

....................................................................................................................................................................................... ....................................................................................................................................................................................... ....................................................................................................................................................................................... Phone (STD Code): ........................................................................................................... Pin: ..................................
Rules & Regulations

(a) (b) (c) (d) (e) (f) (g) Every student is expected to maintain discipline in and outside the classroom. In case of violation of any of the rules & regulations or discipline Received by the institute reserves the right to disenrol any student without any refund of fee. All students are required to bring identity card daily in the class & study matter will be given through identity card only. 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. The batch once allotted at the time of admission will not be changed. Students enrolled under classroom courses will not be transferred or shifted to postal course MADE EASY students are required to submit photocopy of their IES & GATE admit cards. 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).
UNDERTAKING
I, _______________________________________ am applying for admission in ___________________ program of the institute. 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. 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

F5495610OMR Testseries

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SIDE 1

TEST SERIES ENROLLMENT FORM

STUDENT / CANDIDATES NAME (IN BLOCK LETTER ONLY)

TEST CENTRE SEX

Delhi Hyderabad Noida Jaipur Bhopal Other

CORRESPONDENCE ADDRESS (IN CAPITAL LETTERS)

EDUCATIONAL DETAILS (IN CAPITAL LETTERS)

PROOF OF IDENTITY (Submit one of the following proofs)

Name of card holder: Checked by (for office use):

Card No. Signature (for office use):

PERMANENT ADDRESS (IN CAPITAL LETTERS)

Rules & Regulations

Date: Place: Signature of the Candidate

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