ADMISSION SESSION - 2019
Form No
:
Course
:
[Select]
ASPIRE 2021
ASPIRE 2021 Batch-II
ASPIRE 2021 DUAL
ASPIRE ONE 2020
Aspire Plus 2021
BITS PRACTICE
INFOCUS TEST SERIES 2020 (JEE ADVANCED)
INFOCUS TEST SERIES 2020 (JEE MAIN)
SMALL STEP - IX & X CBSE
SMALL STEP - IX & X CBSE + COMPUTER
SMALL STEP - IX & X ICSE
SMALL STEP - IX & X ICSE + COMPUTER
SMALL STEP - IX CBSE
SMALL STEP - IX CBSE + COMPUTER
SMALL STEP - IX ICSE
SMALL STEP - IX ICSE + COMPUTER
SMALL STEP - VIII CBSE
SMALL STEP - VIII CBSE + COMPUTER
SMALL STEP - VIII ICSE
SMALL STEP - VIII ICSE + COMPUTER
SMALL STEP - X CBSE
SMALL STEP - X CBSE + COMPUTER
SMALL STEP - X ICSE
SMALL STEP - X ICSE + COMPUTER
SMALL STEP PLUS IX & X
SWIFT 2020
Student Name
:
Sex
:
Male
Female
Father's Name
:
Mother's Name
:
*
Date of birth
:
[Day]
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
[Month]
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
[Year]
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
Paste recent
3.5 X 4.5 cm passport size colour photograph with date
Std.X School
:
Xth Board
:
CBSE
ICSE
JSEB
BSEB
OTHERS
Year
:
2021
2020
2019
2018
Year
Std.XII School
:
XIIth Board
:
CBSE
ICSE
JSEB
BSEB
OTHERS
Year
:
2021
2020
2019
2018
Year
Current Class
:
VIII Std
IX Std
X Std
XI Std
XII Std
XII Passed
Medium
:
English
Hindi
Prerna Classes Ex student
:
None
Small Step
Aspire
Aspire One
Swift
Triumph
Roll No :
Other Course RollNo
:
%Marks Obtained In The Last Pre-Board/Board Examination(as applicable):
Maths
Science
(OR)
Maths
Physics
Chemistry
Caste
:
General
OBC
SC
ST
Student's Residence
:
Local
Outstation
Batch Time
:
Evening
Morning
Present Address
:
City/District
:
State
:
Pin Code
:
Permanent Address
:
City/District
:
State
:
Pin Code
:
Mother Tel No
:
Father Mobile No
:
Guardian e-mail Address
:
Centre
:
Prerna Tower, Bistupur
DOA
:
[Day]
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
[Month]
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2019
For DD / Cheque :
Number
:
DD / Cheque Date
:
[Day]
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
[Month]
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2019
Bank
:
Branch
:
Amount
:
We have read and understood the terms and conditions for admission to Prerna Classes. We accept and agree to be bound by the same.
Create Date
:
Place
: