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General Courses Admission

INSTITUTE FOR INSPIRATION & SELF DEVELOPMENT
Name (Use Capital Letters)
Father’s Name :
Mother’s Name :
Address :
Date of Birth:
Date month year
Present Address :
 
Phone No. (R) Office:
E-mail :    
Course (s) to be applied for:
IAS WBCS(Exe) WBCS(Preliminary) SSC JEE Languages
MAT CAT                
Others -Choice of subjects if applicable :

Medium of instruction:
(only for WBCS and language courses):
English Bengali
Educational Qualification
Degree/ Examintion Board /University Year of Passing Class Obtained
Working Experience (Please Tick) :
Yes No
If yes, Name & Address of the Organization :
Have you ever appeared for the
IAS WBCS(Exe) WBCS(Preliminary) SSC JEE Languages
MAT CAT                
If yes, Give full details:
Year    
References: (1) (2)
Phone No: Eamil Id:
The source from which you came to know about the institute, News paper/ othters(please specify)
Mention the particulars of the payment:
Cash/ Cheque/ DD No. : Date :
Bank Name: Amount
in words:
Preferred Timings for the class(Please Tick):
Morning Day Evening
Declaration
1. I declare that i will be abiding by the rules and regulations of the institute.
2. I understand that my name as well as my photograph can be published in any newspaper or news magazine, wherever the management deems necessary without any reservation for me.
3. I understand that the course fees/ other fees are not refundable/ transferable under any circumstances.