SIDE 1

TEST SERIES ENROLLMENT FORM

IMPORTANT INSTRUCTION: USE ONLY BLACK BALL POINT PEN TO FILL UP THE FORM
APPLICATION NUMBER (To be assigned by office)
ROLL NUMBER (To be assigned by office)

QUALIFYING DEGREE

DATE OF BIRTH

STUDENT / CANDIDATES NAME (IN BLOCK LETTER ONLY)

Branch

0 CE

1 ME

2 EE

3 EC

4 CS/IT

5 Others

Govt. Employee Class 4

GATE Test Series

Govt. Employee Class 3

IES Test Series

Govt. Employee Class 2

IES & GATE Test Series

Govt. Employee Class 1

Others

Private Job

Doctor

Business

Classroom Test Series

Farming

Postal Test Series

Online Test Series

FATHERS OCCUPATION

EXAM CODE

COURSE

Teaching

Others

General

OBC

SC

ST

Delhi

Fathers Name:. ......................................................................

Noida

Fathers Designation:...............................................................

Hyderabad

Bhopal

CATEGORIES
SEX

Female
Male

MOBILE NUMBER

CORRESPONDENCE ADDRESS (IN CAPITAL LETTERS)

0

Correspondence Address: ......................................................

.................................................................................................

Students e-mail: ....................................................................

Fathers Contact No.:...............................................................

Paste Photo
of Candidate

Pin

Delhi

Hyderabad

Noida

Bhopal

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

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

Wrong Method

TEST CENTRE

Phone (with STD Code): ........................................

MADE EASY Office:

UFPL # 50472

Passing Year

Wrong Method

Wrong Method

Wrong Method

Do not staple

Signature of candidate

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, fathers identity/address proof can be submitted)

Passport

Election I-Card

Driving License

College I-Card

PAN Card

Name of card holder:

Card No.

Checked by (for office use):

Signature (for office use):

Others (Specify)

PERMANENT ADDRESS (IN CAPITAL LETTERS)

.......................................................................................................................................................................................
.......................................................................................................................................................................................
Phone (STD Code): ........................................................................................................... Pin: ..................................

DEMAND DRAFT
DETAILS

DD No.

Amount

Bank Name

City

Rules & Regulations

(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
(I)
(j)

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

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