Enrolment Form

CONNECTINDIA CONTENT WRITING COURSE

FEEDBACK FORM

Registration No.: ____________________ (For Office Use Only)

Pls. affix a passport size photograph at the right hand corner of this form,
failing which your registration may be cancelled.

First Name ________________________ Surname __________________________

Father’s/Husband’s Name _______________________________________________

Father’s/ Husband’s Occupation__________________________________________

Permanent Address ___________________________________________________

___________________________________________________________________
(If you change your address or detail at any point of time during the course, pls.
don’t forget to update us by sending an e-mail to:connectindia@gmail.com)

Phone Nos. (Residence)/ Contact Nos. ____________________________________

E-Mail __________________________________ Cell ________________________

Educational Qualification (candidate) _____________________________________

How are you occupied presently __________________________________________

Why are you interested to pursue a course on Web-Journalism / Content Writing

___________________________________________________________________

___________________________________________________________________

Interested for a 145 hours course _____ 96 hours course_______ 36 hours course_______ 24 hours course______ 10 hours course_______ (Pls. Tick)

Payment should be made via A/C Payee Cheque in favour of either Subhasis Chatterjee or M/S Connect

Cheque Amount: ____________ Bank’s Name & Branch___________________

Cheque No.____________ Dated_________

Please enrol me as a student on the ConnectIndia’s comprehensive Web Content Writing Course. I’ve read and understood the conditions of enrolment and the course dispatch arrangements shown in the prospectus and I agree to them. I also agree to respect the copyright in the course and not to allow any other person to read or use the course or any portion of it in any way whatsoever.

Signature of the candidate________________________________________

Countersigned by Parents/ Husband_________________________________

Date ______________________

Data Protection Act

All details that you provide us will be kept in accordance with the Data Protection Act and will be treated confidentially, for the sole purpose and benefit of ConnectIndia and its administration.

CONDITIONS OF ENROLMENT

1. For the fees quoted, ConnectIndia will provide the course and service
described in the prospectus.

2. If you’re paying your fees by installments, you agree to pay this promptly in
time as they fall due, irrespective of the speed at which you study. If an
installment becomes more than one week overdue, your initial payment will
be forfeited and you’ll be chucked out of the course until and unless you take
further permission to rejoin the course officially.

3. The course material becomes your property as soon as you receive that.

4. ConnectIndia reserves the right to refuse / cancel any application for
enrolment.

5. You agree to follow your tutor’s advice, to study the course consciously in
order to give it a fair chance to help you making a career out of it, to take all
reasonable steps to have your writing published.

6. We’ll award you a certificate of competence as soon you’ll finish off the course
in style. Moreover, we’ll put you directly to work, depending on your level of
understanding and competence.

Complete the Feedback Form and courier this along with your payment to:-

Subhasis Chatterjee
ConnectIndia
210B/1N, Kali Charan Ghosh Road
Kolkata – 700050
West Bengal, India
Cell: +91 9831068105 / 8961629633

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