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: info@allen.in
Acknowledgement & Declaration Form (Session 2025-26 )
Application form no: 1008233356 Photograph
Name of Applicant: Sumit Kumar
Father's Name: Turant Lal Ray
Mother's Name: Rangeela Kumari
Gender: Male Medium: English
Stream: Jee (Main + Advanced)
Center: KOTA
Course Name: NURTURE PHASE-II / 101002
Muzaffarpur Bihar Village Vishambarpatti
Address: City: Muzaffarpur ,
District: Muzaffarpur , State: Bihar , Pin: 843129
Contact Details: Phone No.: - Mobile No: 6204907119
Email: sumitkumaryadav2425@gmail.com
Account Creation Date &
Apr 5 2025 7:24PM
Time:
Profile Creation Date &
Apr 5 2025 8:51PM
Time:
Online Application Form
Apr 5 2025 9:18PM
Fee Deposit Date & Time:
Declaration
I hereby declare
Admission for the coaching center program at ALLEN is voluntarily, out of my own interest and accord.
All information furnished by me in the Application Form is correct to the best of my knowledge. In the event of any
information found to be incorrect or false, admission may be cancelled without any refund of fee paid.
I have read and understood, and shall obey in word and spirit, all applicable guidelines, policies, rules and regulations of
ALLEN (as may be amended from time to time).
I shall be solely responsible in case of rustication from ALLEN and / or termination of enrollment by ALLEN including the
initiation of any legal actions by ALLEN, on grounds of breach of applicable guidelines, policies, rules and regulations and /
or any misconduct or illegal activities, whether on or off-campus including at any student accommodation facilities.
If found absent from classes for a period of 30 (thirty) days in continuity without any notice to ALLEN, ALLEN retains the
right to cancel the admission and will be discharged from all responsibilities and liabilities, without any obligation for a refund
of course fee.
In case of selection in the medical / engineering entrance exams, national or international Olympiads and / or any other
examination, ALLEN reserves its exclusive right to use the Candidate’s information for its marketing and publicity purposes.
I authorize ALLEN to contact me through phone calls, automated phone calls, emails, SMS, WhatsApp and / or push
notifications alerts.
Any unauthorized downloading or uploading of videos – whether on campus or at student accommodation facilities, taking
screenshots, recording lecture videos, broadcasting of live / recorded classes on open / public forum, sharing study
materials, test papers, or any other information that has been provided by ALLEN, is strictly prohibited.
I understand that the study materials, contents, notes provided by ALLEN is solely ALLEN's intellectual property.
I have read all the rules (including the refund rules) and regulations of ALLEN's coaching centers.
I have read all the details set out in the application kit and I do agree to follow the instructions as applicable.
Note: This is a computer generated document hence no signature required. Print Date:05-Apr-2025 21:26:10
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:05-Apr-2025 21:26:10
