AFFIX PHOTO HERE

ALTIUS ACADEMY
ADMISSION FORM CLAT [Common Law Admission Test] COURSE
Instructions: 1. Fill in all the details in CAPITAL letters and tear along the perforation. 2. Affix one passport size photo.

Name [Write your

name in capital letters]

Date of Birth

Fathers name & occupation Address for communication

[Write your complete address with pin code]

Contact number [Mention

the STD code]

Landline : Students Mob No: Student: Parent: Parents Mob No:

Email Id

The Year you would appear in CLAT [Tick] Class in which you
are studying now

2014

2015

2016

Name of School/college Course undertaken with ALTIUS ACADEMY

Fee [Rs] Batch (Pl tick) Monday, Wednesday, Friday Tuesday, Thursday, Saturday

6 months class room course [6 months class

room course+ 1 month revision + test series on the lines of CLAT]

25,000/-

How did you come to know us?

FRIEND

INTERNET

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Fee Paid

Rs.

Signature of student

Signature of parent

Date