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    Declaration - 1003646573 - 25-06-2024 20 - 29 - 49

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    bishnoia870

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    Declaration - 1003646573 - 25-06-2024 20 - 29 - 49

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    bishnoia870
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    Declaration_1003646573_25-06-2024 20_29_49

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    Declaration - 1003646573 - 25-06-2024 20 - 29 - 49

    Uploaded by

    bishnoia870

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    ALLEN Career Institute Pvt. Ltd.

    Corporate Office:
    “SANKALP”, CP-6, Indra Vihar, Kota, (Rajasthan) - 324005
    Ph.: +91-744-275-7575
    Website: www.allen.ac.in | E-mail: [email protected]

    Acknowledgement & Declaration Form (Session 2024-25 )


    Application form no: 1003646573 Photograph

    Name of Applicant: Arvind Bishnoi


    Father's Name: Jagdish Bishnoi
    Mother's Name: Nirma
    Gender: Male Medium: English
    Stream: Jee (Main + Advanced)
    Center: JODHPUR, PAOTA
    Course Name: NURTURE PHASE-VII / 101007
    Santosi Mata Mandir Road ,Krisi Mandi ,Mandore
    Address: City: Jodhpur ,
    District: Jodhpur , State: Rajasthan , Pin: 342007
    Contact Details: Phone No.: - Mobile No: 7023771829
    Email: [email protected]
    Account Creation Date &
    Jun 22 2024 7:51PM
    Time:
    Profile Creation Date &
    Jun 22 2024 7:54PM
    Time:
    Online Application Form
    Jun 25 2024 9:59AM
    Fee Deposit Date & Time:

    Declaration
    I hereby declare
    that I am seeking admission in my own interest and accord.
    that I shall be fully responsible for any accident / mis-happening occurring with me/by me inside / outside the institute's
    premises and institute will not responsible in any manner.
    that I shall be responsible for my rustication on grounds of misconduct, misuse of mobile phones, misuse of internet or any
    illegal and indecent activity.
    that in case of my selection in Medical / Engineering Entrance Exams / NTSE & Olympiads, the institute reserves the right to
    use my name, photo and other information for publicity purpose.
    that I solemnly affirm that the institute has rights to send me emails (e-newsletters), sms alerts, WhatsApp Messages (Text,
    Images, Video, Documents) and post on the mentioned communication details.
    that all the information furnished by me in the ONLINE Application Form or in any other form etc. is correct to the best of my
    knowledge. I understand that in the event of any information found to be incorrect or false, my admission may be cancelled
    without any refund of fee.
    that I have read all the instructions of the Information Bulletin / available Online and I do agree to follow the instructions as
    applicable.
    that I agree to abide by the Refund Rules of the Institute.
    I agree that all dispute are subject to Kota (Rajasthan) jurisdiction only.

    Registered & Corporate Office : “SANKALP”, CP-6, Indra Vihar, Kota (Rajasthan) - 324005
    CIN: - U80100RJ2021PTC077131

    Note: This is a computer generated document hence no signature required. Print Date:25-Jun-2024 20:29:49

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