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: 1008266182 Photograph
Name of Applicant: Agamjot Singh
Father's Name: Sukhchain Singh
Mother's Name: Harpinder Kaur
Gender: Male Medium: English
Stream: Pre-Medical
Center: AMRITSAR
Course Name: NURTURE PHASE-III / 303003
Gopal Nahar 441/13 Gurdaspur
Address: City: Gurdaspur ,
District: Gurdaspur , State: Punjab , Pin: 143521
Contact Details: Phone No.: - Mobile No: 7589002773
Email: q0125856@gmail.com
Account Creation Date &
Apr 28 2025 2:14PM
Time:
Profile Creation Date &
May 3 2025 10:21AM
Time:
Online Application Form
May 3 2025 10:31AM
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:04-May-2025 10:26:05
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:04-May-2025 10:26:05
