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: 1008257930 Photograph
Name of Applicant: Prachi Singh
Father's Name: Sanyog Singh
Mother's Name: Manju Sungh
Gender: Female Medium: English
Stream: Pre-Medical
Center: LUCKNOW, HAZRATGANJ
Course Name: LEADER PHASE-II / 303032
Mohala Thakuran Tola Tambaur
Address: City: Sitapur ,
District: Sitapur , State: Uttar Pradesh , Pin: 261208
Contact Details: Phone No.: - Mobile No: 7395043715
Email: singhsaumya248@gmail.com
Account Creation Date &
Apr 10 2025 2:23PM
Time:
Profile Creation Date &
Apr 18 2025 2:29PM
Time:
Online Application Form
Apr 23 2025 10:35PM
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:23-Apr-2025 22:36:47
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:23-Apr-2025 22:36:47
