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Admission Form: Form No: Personal Information

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Registered Office: 23/2/2 Bhagaban Chatterjee Lane, Howrah-1


Phone: 9836131393/8334064626
E-mail: chhandakhazra1@gmail.com
Website: www.chhandaksirphysics.com

Admission Form

Form no:
Personal Information
First Name Middle Name Surname

Current Address:

Date of Birth:
Gender: MALE FEMALE
Mobile No:
Category: General OBC SC ST
Parents Occupation:

Educational Information
Class X Class XI-XII
Name of School: Name of school:
Address of School: Address of School:

Chhandak Sir Physics Classes-- www.chhandaksirphysics.com 9836131393/8334064626 Page 1


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Board: CBSE ICSE WBBSE Board: CBSE ICSE WBBSE


Medium: English Hindi Medium: English Hindi
Bengali Others Bengali Others
Detail of Marks Obtained Detail of Marks Obtained
Subject Full Marks Marks Obtained Subject Full Marks Marks
Obtained
Maths Maths
Physics Physics
Chemistry Chemistry
Biology Biology
English English
## Whether Candidate is attached with any of the following institute:

Fiitjee Akaash Resonance

Allen Pathfinder Others

Admission Details
Class XI XII XII(Pass out)
Courses: BOARD
Medical : CBSE-PMT/NEET WBJEE
Engineering: IIT-JEE WBJEE
Kadamtala
Mandirtala Howrah
Bally

Dumdum
Centres: Ballygaung Kolkata

Alipur duar
Coachbihar North Bengal

Signature of parent/guardian Signature of candidate


Date of admission: Amount:
Receivers signature: Form no:

RESULTS
1. ARNAB BIR 17TH (ENG)
TH
2. ROKTIM MUKHERJEE 20 (MED)
3. RUKSANA BEGUM 21ST (MED)
TH
4. SABRINA FARHEEN 37 (MED)
5. TANOY KR. SARKAR 49TH (MED)
6. SAMIPENDU DAS 51ST (ENG)
7. SOUVIK MONDAL 53RD (ENG)
8. ASIF IQBAL 62ND (ENG)

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9. SOHAM BHUNIA 69TH (MED)


TH
10.SK. MUSRAIL RAHAMAN 84 (MED)
Total selection in (MED/ENG) 196 number of students
Total selection in JEE ADVANCE 31number of students
Total selection in Medical (WBJEE 2014) 65 numbers of students.
Total selection in Medical (WBJEE 2014) 65 numbers of students.
More than 40 numbers of students scored over 400 in H.S(2014).
More than 40 numbers of students scored over 90% in ISC(2014).
RULES &REGULATIONS:
Fees should be paid by 10th of every month.
When pupil is absent from coaching centre or a particular class, it is responsibility of the
guardian/ parent to inform the coaching centre authorities.
During exam period, students must attain the classes, if any case he/she was absent during
that day, then on the next day, he/she must come to the class with his parent/guardian .
Defacing or damaging coaching centre property is unacceptable. This includes writing
messages on desk and walls. If any student found to do so, then he/she has to pay a
penalty of Rs. 100/- against the charge.
Pupils are not allowed to use mobile phones during class period. If any student found to
do so, then his/her phone is taken by the authorities and their mobile phone will be given
back to them after meeting their parents.

THE ADMISSION FEES IS NON REFUNDABLE

I hereby certify that the information given above is complete and correct. If any information
in the form is found false/incorrect, my candidature against this admission shall stand
cancelled.
I have read the coaching rules and regulations and assure to obey the same in true sense.

Signature of parent/guardian Signature of candidate


Date of admission: Amount:
Receivers signature: Form no:

Chhandak Sir Physics Classes-- www.chhandaksirphysics.com 9836131393/8334064626 Page 3

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