To, The Incharge - DLP Division Aakash Tower, Plot No.

4, Sector-11, Dwarka, New Delhi-110075

Affix your recent passport size photograph here.

Admission Form for Aakash iTutor DLP Courses

COURSE APPLIED FOR

Course Code Course Name

Please mark (4) against the course you wish to apply)

Course Code

Course Name

DLP-Fi-8B DLP-Fi-9B DLP-Fi-XB DLP-Fi-XC DLP-Fi-XP DLP-Mi-2B

Foundation VIII iTutor Basic Course 2013 NURTURE 9x iTutor Basic Course 2013 Nurture X cum NTSE iTutor Basic Course 2013 Nurture X cum NTSE iTutor Classic Course 2013 Nurture X cum NTSE iTutor Premium Course 2013 Two Years iTutor Basic Course for Medical (NEET) - 2014

DLP-Mi-1B/M One Year iTutor Basic Course for Medical (NEET) with Mathematics 2013 DLP-Mi-1C DLP-Mi-1P DLP-Ei-2B One Year iTutor Classic Course for Medical (NEET) - 2013 One Year iTutor Premium Course for Medical (NEET) - 2013 Two Years iTutor Basic Course for JEE Main & Advance 2014

DLP-Ei-2B/B Two Years iTutor Basic Course for JEE Main & Advance with Biology 2014 DLP-Ei-2P DLP-Ei-1B Two Years iTutor Premium Course for JEE Main & Advance 2014 (Select Topics) One Year iTutor Basic Course for JEE Main & Advance 2013

DLP-Mi-2B/M Two Years iTutor Basic Course for Medical (NEET) with Mathematics-2014 DLP-Mi-2C DLP-Mi-2P DLP-Mi-1B Two Years iTutor Classic Course for Medical (NEET) - 2014 Two Years iTutor Premium Course for Medical (NEET) - 2014 One Year iTutor Basic Course for Medical (NEET) - 2013

DLP-Ei-1B/B One Year iTutor Basic Course for JEE Main & Advance with Biology 2013 DLP-Ei-1P1 DLP-Ei-1P2 One Year iTutor Premium Course for JEE Main & Advance 2013 (XI) (Select Topics) One Year iTutor Premium Course for JEE Main & Advance 2013 (XI+XII) (Select Topics)

SEPARATE PRINTED BOOKS

NTSE - Class VIII Books Medical Books (XI + XII) - One Year Nurture IX Books Nurture X Books Medical Books (XI + XII) - Two Years Math Books - One year Engineering Books (XI + XII) - Two Years

Engineering Books (XI + XII) - One Year

Respected Sir, I want to take admission in your Institute for the Distance Learning Program Course marked (4) in the box. I have read the 'Terms & Conditions' of the institute given overleaf and agree to abide by the same. My particulars are given below:
(It is compulsory to fill the form clearly in CAPITAL LETTERS only)

First Name Fathers/Guardians Name Mothers Name Occupation of Father Date of Birth
(DD/MM/YYYY)

Last Name

Gender M

Category
(GEN / SC / ST / OBC / PH)

Blood Group

(Please Tick P the relevant box)

Residence Address

City

State
(Number)

Pincode Mobile

Phone
(STD Code) (Any Other)

(Parents)

Mobile
(Students)

Email

Address for Correspondence

(Please ignore if same as Residence Address)

City

State Fax
(STD Code) (Number) (Any Other)

Pincode

Phone

(STD Code)

(Number)

School / College Name & Address

Student Class category: VIII studying IX studying X studying XI studying XII studying

P.T.O.

Marks Obtained

% (X Board, Sc. & Maths - Aggregate)

(XII Board, PCB / PCM - Aggregate)

CBSE

ISC

State Board

Any other

(Attach a Photocopy of Your Original Marksheet)

Eligibility for Concession:

5%

10%

15%

20%

Others ....................................

How did you come to know about Aakash?

Promotions Team

Newspaper

Teachers

Friends/Relatives

Ex-Aakashians

Website

Radio

Date:

Sincerely,

Place:
(FOR OFFICE USE ONLY)

(Signature of the Student)

Concession of Scholarship:
Amount (Rs.):

5%

10%
Drawn on:

15%

20%

(Please tick ? the relevant box)

Date:

Cash / Demand Draft No.:

Registration No.

Office Receipt No.:

Receipt Date:

Prov. Receipt No. (if any) Counsellor (Name)

Admission Place:

Branch

Info. Centre

Promotions Executive

Terms & Conditions

1. 2. 3. Incomplete form will be rejected. It is compulsory to attach self attested photocopy of marksheet of class IX / X / XII. Students once enrolled into DLP courses cannot claim for refund of fee or part of the fee; if he/she becomes disinterested during the course due to any reason whatsoever. It is for the student to see whether he/she is eligible for a certain Entrance examination or not. The Institute does not hold itself responsible if a student's admission form cannot be forwarded or is rejected by the examination body on any ground whatsoever. Such a student cannot claim a refund of the whole or any part of the fee he/she has paid to the Institute. It is compulsory for a student to attach a recent passport size photograph on the admission form. Institute reserves the right to use the photograph for publicity in case the student secures position / succeeds in Entrance Exams. The student should also staple three extra photographs with the form. The responsibility of getting admission form forwarded to the examining body is that of the student himself/herself or that of the Parents / Guardian. 7. 8. AESL reserves the right to make any change in its programs without any prior notice to anybody. If the iTutor device or SD card is lost / misplaced once delivered, then a student can ask for a new device against the payment of `10,000 and Content SD card for `1000 respectively through Demand Draft in favour of 'Aakash Institute' or 'Aakash IIT-JEE or 'Aakash Foundations' payable at New Delhi. Any change of address or phone numbers should be notified to the DLP Division without any delay through a written application. If the despatch is returned due to change of address or any reason whatsoever, ` 500 will be charged for sending the despatch again. If at any point of time, the Central Govt. further increases service tax, (existing rate of service tax is 12.36%) the extra amount of service tax will be borne by the students from the date of enforcement of the act by the Govt. Students enrolled with Aakash will have to provide photocopy of Admit Card of All Entrance Exam. as soon as they receive their admit cards from the examining body. In case of any dispute or difference between you and Institute regarding the interpretation of these terms and conditions, non-payment of any claim or any dispute arising out of or in pursuant to these terms and conditions, the same shall be referred to Sole Arbitrator who shall be appointed by Chairman of M/s Aakash Educational Services Ltd. The proceedings shall be conducted at New Delhi under the provisions of Arbitration & Conciliation Act and the Courts at Delhi only shall have the jurisdiction over the matter and/or for enforcement as the case may be. If an Arbitrator to whom the matter is referred refuses to act or for any reason, does not enter the reference or after entering into the reference proceedings are abandoned or kept in abeyance or not proceeded with, it shall be lawful for the Chairman of M/s Aakash Educational Services Ltd. to appoint another person to act as Arbitrator in the manner aforesaid. Such person shall be entitled to proceed with reference from the stage at which was left by his predecessor, if both the parties consent to this effect, failing which the Arbitrator will be entitled to proceed denovo. If any student fails to receive the device within 15 days from the date of despatch, kindly inform the DLP Division telephonically or by writing an email.

4.

9.

10.

5.

11.

13.

6.

12.

Terms and Conditions for Aakash iTutor

1. Warranty will be valid only when the original duly filled TAX INVOICE along with this WARRANTY card is presented together with the defective product. Edutor reserves the right to decline warranty service, if the above documents cannot be presented or if the information contained is incomplete or tampered. This warranty shall not cover any damages resulting from adaptations, reverse engineering or adjustments which may be made to the product either software or hardware. This warranty will not apply if the type or serial no, on the product has been altered, removed or defaced. 7. 5. This warranty does not extend to labels or any external accessories such as manuals, documents, plastic covers, paper bags. 9. 6. 2. This warranty does not cover the damage caused to the product due to improper installation by customer and / or connecting the product to equipment not approved by Edutor and deficiency in product performance due to electricity disturbances while charging. This warranty does not apply to normal wear and tear to audio, video, LCD screens if the product is used in commercial, business, industrial, educational or rental applications. This warranty does not cover the risk to the product caused by accident, lightening, water, fire, other acts of God, improper ventilation, dropping or excessive shock or any external cause beyond Edutor's control. This warranty does not cover LCD, Touch screen, plastic case breakages. This warranty does not affect the consumer's statutory rights under applicable Indian Laws, nor the consumer's rights against the dealer or Edutor arising from their sales/purchase product.

10.

3.

4.

8.

Check List:

1. 2. 3. 4. 5. 6.

Three Passport Size Photographs along with the from. Photocopy of marksheet of class IX / X / XII (self attested by the student). DD in favour of Aakash Institute or 'Aakash IIT-JEE' or 'Aakash Foundations' payable at New Delhi. Centre Code number and Centre Name on Admission Form should be properly filled. If you are an Ex-Aakshian, attach a photocopy of Identity Card issued by Aakash along with the Admission Form to avail concession. IIT-JEE / AIEEE Preliminary Exam. qualified / NTSE qualified / Olympiad Toppers should attach a photocopy of proof of their qualification along with the Admission Form of Aakash Institute to avail concession.

I have read the terms & conditions of AESL as well as Aakash iTutor and various policies of the Company as mentioned in the prospectus & promise to abide by the same.

(Signature of the Parent/Guardian)

(Signature of the Student)

* Note : It is mandatory for Student & Parent to sign at the appropriate places failing which admission form will not be processed and will be rejected.