ii) Submission of false Undertaking is punishable offence.
If it is found at any stage that false
Undertaking was submitted, admission shall be cancelled and legal proceedings shall be initiated,
for which candidate/parent/guardian shall be responsible.
Appendix 5
GURU GOBIND SINGH INDRAPRASTHA UNIVERSITY
(A State University established by the Govt. of NCT of Delhi)
Accredited as NAAC A++ Grade
Photograph
MEDICAL CERTIFICATE** duly attested by
(FOR THE ACADEMIC SESSION 2024-25) the officer who
has certified
(TO BE SUBMITTED AT THE TIME OF COUNSELLING/ADMISSION)
this certificate
I certify that I have carefully examined Shri/Km/Smt.*_______________________________________
son/ daughter/wife of Shri/Smt.* __________________________________________________whose
signature is given below. Based on the examination, I certify that he/she is in good mental and physical
health and is free from any physical defects which may interfere with his/her studies including the active
outdoor duties required of a professional. Visible Mark of Identification
_____________________________________________
Signature of the Candidate__________________________________________
Plac :
e
Date :
Name & Signature of the
Medical Officer with Seal and
Registration Number
* Strike whichever is not applicable.
** To be signed by a Registered Medical Practitioner holding a Medical degree.
Note : Use photocopy of this Form
ADMISSION BROCHURE FOR GRADUATE PROGRAMMES 2024-25 Page 9
Appendix 6
GURU GOBIND SINGH INDRAPRASTHA UNIVERSITY
(A State University established by the Govt. of NCT of Delhi)
ADMISSION VERIFICATION FORM FOR THE
ACADEMIC SESSION 2024-25
Name of Candidate: (Mr./Miss/Mrs.) _________________________________________________________________
Father’s/ Guardian’s Name: (Mr./ Shri) ___________________________________________________________________
Address:______________________________________________________________________________________
PIN Code_____________ Tele. No. (with STD code) _________________Mobile No. _________________________
Email:________________________________________________________________________________________
Minority Community (If applicable) ______________ (Sikh / Muslim / Jain / Christian)
NLT/CET/CUET Application No._____________ Category (SC/ST/OBC/Defence/PWD/Kashmiri Migrant/Army)
_____________ NLT /CET /CUET Rank______________ Programme ______________________
1. School / College location of qualifying examination____________________________ (Delhi / Outside Delhi)
2. Date of Birth _______________Age as on 1-8-2024: years_______months ____days ___________
(As per Secondary School Certificate)
3. Passed Senior Secondary Examination / Three year Diploma in Engg/B Sc Graduation (3 yrs) ______________
4. Aggregate percentage of all subjects in Sr. Secondary Examination/Dip. in Engg/ B Sc Graduation (3 yrs) _____
5. Passed in English in 12th Class (Yes/No) _____________
6. PCM/PCBM Percentage in 12th Class __________________________________________________________
7. Percentage in qualifying degree as per the eligibility condition specified in PART A of the Admission Brochure:
_____________________________
8. Passed in Maths / Computer Science / Computer Applications in 12th Class _____________________________
9. Category Certificate SC/ST/OBC/PWD/Defence/Kashmiri Migrants/Minority Community (Attach photocopy):
10. Character Certificate (Attach photocopy) (Yes/No) _______
11. Medical Certificate (Attach Original) (Yes/No) __________
12. Passed Graduation in the year ________________Percentage of marks in graduation _____________________
13. Passed Post-Graduation in the year____________ Percentage of marks in post-graduation _________________
14. (a) CAT/CMAT/CET Score/Rank ____________________
(b) Year of Passing _______________________
15. Details of Demand Draft(s) for Submission of fees
Amt:____________ DD No.________ Bank/Branch_______________
Amt:____________ DD No.________ Bank/Branch_______________
Amt:____________ DD No.________ Bank/Branch_______________
I solemnly affirm that the information furnished above is true and correct in all respects. I have not concealed any
information. I realize that if any information furnished herein is found to be incorrect or untrue, I shall be liable to criminal
prosecution and also forgo my claim to the seat in the college. Further, that my candidature for examination/selection and
admission to the course is liable to be cancelled. I agree to abide by the rules & regulations of the University.
Signature of the Parent/Guardian & Date Signature of Candidate & Date
FOR OFFICE USE ONLY
Certificates Checked and Verified by University official/Officer during counselling:
Signature of the Deputed Officers/Officials___________________________________
Name of the Officer/Officials _____________________________________________
University Enrolment No.__________________________________
Note: Use Photocopy of this form
ADMISSION BROCHURE FOR GRADUATE PROGRAMMES 2024-25 Page 10
Appendix 7
GURU GOBIND SINGH INDRAPRASTHA UNIVERSITY
(A State University established by the Govt. of NCT of Delhi)
Accredited as NAAC A++ Grade
UNDERTAKING BY THE STUDENT WITH RESPECT TO ANTI RAGGING
I, _________________________________________S/D of Mr./ Mrs. /Ms.
_____________________________ , having been admitted to Programme/Stream
____________________, at (Institute/College)_____________________________have received a copy
of the UGC Regulations on Curbing the Menace of Ragging in Higher Educational Institutions, 2009,
(hereinafter called the “Regulations”) carefully read and fully understood the provisions contained in the
said Regulations.
2) I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging.
3) I have also, in particular, perused clause 5 and clause 6.1 of the Regulations and am fully aware of the
penal and administrative action that is liable to be taken against me in case I am found guilty of or
abetting ragging, actively or passively, or being part of a conspiracy to promote ragging.
4) I hereby solemnly aver and undertake that
a) I will not indulge in any behavior or act that may be constituted as ragging under clause 3 of
the Regulations.
b) I will not participate in or abet or propagate through any act of commission or omission that
may be constituted as ragging under clause 3 of the Regulations.
5) I hereby affirm that, if found guilty of ragging, I am liable for punishment according to clause 9.1 of
the Regulations, without prejudice to any other criminal action that may be taken against me under any
penal law or any law for the time being in force.
6) I hereby declare that I have not been expelled or debarred from admission in any institution in the
country on account of being found guilty of, abetting or being part of a conspiracy to promote, ragging;
and further affirm that, in case the declaration is found to be untrue, I am aware that my admission is
liable to be cancelled.
Declared this ___day of __________ month of ______year.
______________________________________
Signature of deponent
Name:
Address:
Telephone/Mobile No.
VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit
is false and nothing has been concealed or misstated therein.
Verified at ____on this the ____of _____.
____________________
ADMISSION BROCHURE FOR GRADUATE PROGRAMMES 2024-25 Page 11
Signature of deponent
Appendix 8
GURU GOBIND SINGH INDRAPRASTHA UNIVERSITY
(A State University established by the Govt. of NCT of Delhi)
Accredited as NAAC A++ Grade
UNDERTAKING BY PARENT/GUARDIAN WITH RESPECT OF ANTI RAGGING
I, Mr./Mrs./Ms. _____________________________________________________ (full name of
parent/guardian) father/mother/guardian of, (full name of student with admission/registration/enrolment
number), having been admitted to ______________________________________(name of the
institution), have received a copy of the UGC Regulations on Curbing the Menace of Ragging in Higher
Educational Institutions, 2009, (hereinafter called the “Regulations”), carefully read and fully understood
the provisions contained in the said Regulations.
2) I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging.
3) I have also, in particular, perused clause 5 and clause 6.1 of the Regulations and am fully aware of the
penal and administrative action that is liable to be taken against my ward in case he/she is found guilty of
or abetting ragging, actively or passively, or being part of a conspiracy to promote ragging.
4) I hereby solemnly aver and undertake that
a) My ward will not indulge in any behave our or act that may be constituted as ragging under
clause 3 of the Regulations.
b) My ward will not participate in or abet or propagate through any act of commission or
omission that may be constituted as ragging under clause 3 of the Regulations.
5) I hereby affirm that, if found guilty of ragging, my ward is liable for punishment according to clause
9.1 of the Regulations, without prejudice to any other criminal action that may be taken against my ward
under any penal law or any law for the time being in force.
6) I hereby declare that my ward has not been expelled or debarred from admission in any institution in
the country on account of being found guilty of, abetting or being part of a conspiracy to promote,
ragging; and further affirm that, in case the declaration is found to be untrue, the admission of my ward is
liable to be cancelled.
Declared this ___day of __________ month of ______year.
______________________________________
Signature of deponent
Name:
Address:
Telephone/Mobile No.:
VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit
is false and nothing has been concealed or misstated therein.
ADMISSION BROCHURE FOR GRADUATE PROGRAMMES 2024-25 Page 12
Verified at on this the of , .
________________
Signature of deponent
ADMISSION BROCHURE FOR GRADUATE PROGRAMMES 2024-25 Page 13
