Trademark No.: 4461414
Udyam Registration No.: UDYAM-DL-08-0031101

Trademark No.: 4461414

Udyam Registration No.: UDYAM-DL-08-0031101

Nishant Academy

A Bond Of Trust With A Genuine Legacy

Session 20 20

PIQ FORM

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(1) Application No.

(2) Date:

(3) Joining Date

(4) Centre

(5) Home Tuition / Schooling:

(6) Class Mode:

(7) Teacher's / Trainer's Name:

(8) Class / Grade:

(9) School / College Name:

(10) Previous Term / Year Performance/Marks :

Maths

English

Science

S.ST

(11) PCMB

History

Pol.sc

Other

(12) Applicant's Name.

(13) Date of Birth

(14) Father's Name

(15) Mother's Name.

(16) Guardian's Name

(17) Email address

(18) Address

(19) Contact No.

Alternate Contact No.

(20) School's Board

(21) University

(22) Tuition

(1st to 12th) class

ARTS

Other

Regular

Crash Course

CBSE

ICSE

IGCSE

Other

(23) Spoken English

Basic

Intermediate

Advance

(24) IELTS/TOEFL/PTE

(25) Entrance Coaching

(26) Foreign Languages

(27) Dance: Indian

Western

(28) Music : Indian

Western Music

(29) Yoga

(30) Sports

(31) Arts & Crafts

(32) Monthly Fee

(33) Annual Fee

(34) Receipt No.

(35) Date

(36) Amount Received

(37) Due Amount