Application for the Purchase of Tablet Computer

Name of the Student:

Enrollment Number:

Father / Legal Guardians Name:

Study Centre:

Batch Code:

Mobile Number:

Payment Plan(All prices are inclusive of applicable Taxes)

Class

Cheque
Amount

Cheque Date

16999/-

18th April 2016

1000/-

10th October 2017

16499/-

18th April 2016

1000/-

10th October 2016

15999/1000/-

16999/-

18th April 2016

15999/500/-

16499/-

18th April 2016

Rate (INR)

Qty

Amount

Tablet Computer (Samsung T561)

Samsung Knox (Security Software of Samsung)
Samsung Knox (Security Software of Samsung)*

15999/- per Piece

500/Per year
500/Per year

1 Nos
2 Years
2 Years

15999/1000/1000/-

Tablet Computer (Samsung T561)

Samsung Knox (Security Software of Samsung)
Samsung Knox (Security Software of Samsung)*

15999/- per Piece

500/Per year
500/Per year

1 Nos
1 Year
2 Years

15999/500/1000/-

XI

Tablet Computer (Samsung T561)

Samsung Knox (Security Software of Samsung)

15999/- per Piece

500/Per year

1 Nos
2 Years

XII

Tablet Computer (Samsung T561)

Samsung Knox (Security Software of Samsung)

15999/- per Piece

500/Per year

1 Nos
1 Year

IX

Item

Please tick () the class now you are in

Cheque in favor
Of

Edfora Infotech
Pvt Ltd

* This PDC will be cancelled and returned to students who are exiting using Exit option if applicable as per rules. You have an option to merge this amount in the
1st Instrument in case you have not opted / opting for the Exit option.
Last Date to submit this duly filled Form with payment Cheques 14th April 2016

Tick Here If you want to order a safety case for the Tablet with your name printed on it. Attach a Separate Cheque of Rs 650/- in Favor of Edfora Infotech Pvt
Ltd dated 18th April 2016. Please note that this will be a Chinese case with no warranty. The sample of the case is available in FIITJEE Office.
Payment Details: (Please write your Name and Enrollment Number Behind the Cheque)
S. No
Instrument No:
Drawn From:

Instrument Date

Amount Paid:

1
2
3.
Declaration by the student and parent...
1. We are requesting Edfora to buy the above mentioned Tablet from Samsung and understand it very clearly that the responsibility of Edfora will be limited to
delivering a sealed and undamaged Original box of Samsung Tablet Computer and for issuing a Valid VAT Invoice. The device is covered under warranty by
Samsung for one Year. For any fault / defect well directly contact the Samsung Service Centre. Edfora or FIITJEE will not be responsible towards any academic
or other loss due to a fault / defect in the Tablet. In the unlikely event if the deal with Samsung fails for any reason, Edfora reserve the right to cancel this
scheme and return your payments without any interest or further obligation.
2.

We authorize Edfora to disable all auxiliary services including but not limited to Camera, Calling, messaging, Internet access, Games, Apps Download, Social
Media etc that are not required for the academic purpose. Internet access will be enabled only to the portals approved by FIITJEE and required to be referred
for the purpose of FIITJEE Program. These blockings will be removed once the duration of the Samsung Knox Software expires and course comes to an end.

3.

I agree to pay Rs 500/- as Bouncing charges and Rs 50/- per day as Late Fee in case my Cheque towards Samsung Knox gets bounced for any reason. I also
agree to provide one postpaid / Pre Paid 3G data Sim to my ward with sufficient monthly data limit at my own cost. Accessories like Power Bank, Screen
Guard, and Safe Cover etc will also be procured by us at our own cost. We also declare that Neither FIITJEE nor Edfora has charged us any money extra over
and above the Course Fee of the FIITJEE Program, Cost of this Tablet and the Price of Samsung Knox.

4.

The shelf life of this tablet is 2/3 Years. Students presently in class IX/X may need to buy an upgraded Tablet during the course of the program at FIITJEE on
the need basis. Well be responsible on our own for the safekeeping of the Tablet Computer at Home, School and FIITJEE etc. Neither FIITJEE nor Edfora or
School will be responsible for any loss / damage / theft of the Tablet Computer. In such an event well be liable to replace it at our own cost.

5.

The order once placed cant be cancelled or modified for any reason. The money paid is nonrefundable. The delivery of the Tablet will be after 3/4 weeks
from the date of actual presentment of the Cheque. Any dispute regarding this can be vested in the courts of Delhi / New Delhi Only.

Signature of the Student

Date:
Place:

Signature of the Parent / Legal guardian

Date:
Place: