Chotiwala's Tutorial & Guidance

FOR

M.D. (Ay.)/ M.S. (Ay.) ENTRANCES TEST, U.P.S.C., STATE & CENTRAL SERVICES PRELIMINARY TEST PREPARATION

(Chotiwala's Ayurveda, 492, C. P. Mission Compound, Near Preeti Provisional Store, Gwaliar Road, Jhansi - 284003)

(To be filled by the Office)
Receipt No.
Membership Code
Serial No.

Details of Applicant
1.
Name of Donor And His/Her Full Address
2.
Phone No.Residence with S.T.D. code
-
3.
Phone No. Office with S.T.D. code
-
4.
Mobile No.
5.
Email
6.
Category (Tick whichever is applicable)
Group I
Group II
Group III
Group IV
Group V
Group VI
Group VII
 Group VIII
 
     
7.
Details of Donation (Tick whichever is applicable)
DD CQ Cash Other
8.
Amount
9.
DD/CQ
10.
 Date
11.
Name of Issuing Bank & Branch
12.
Name of Drawee Bank & Branch
13.
Receipt No.
14.
Date
Details of donation, if made earlier (Tick whichever is applicable)
DD Cheque Cash Other
1.
Amount
2.
DD/Cheque No.
3.
Date
4.
Name of Issuing Branch
5.
Name of Drawee Branch
6.
 Receipt No.
7.
Date
Signature of Accountant Signature of Applicant
Note : Drafts and Cheques should be in favour of Anju Sachan.
Rules and regulations for membership of Chotiwala's Tutorial & Guidance (A unit of Chotiwala's Tutorial & Guidance, 492, C. P. Mission Compound, Near Preeti Provisional Store, Gwaliar Road, Jhansi - 284003) alongwith its objectives.
1.All Membership are subject to the rules and regulations of the Chotiwala's Tutorial & Guidance , in existence.
2.Only individual membership will be accepted and membership is nontransferable. The Chotiwala's Tutorial & Guidance will take any decision on the application of the natural heir of a member for the transfer of membership to him/ her on the demise of the concerned member
3.The membership does not entitle or create any right to the ownership of the Chotiwala's Tutorial & Guidance.
4. Contribution for membership of Chotiwala's Tutorial & Guidance is entirely non-refundable.
5. Membership shall automatically result in termination in the event of indulging in any activity which violates the rules and regulations of the Chotiwala's Tutorial & Guidance