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 11(A)
GURU GOBIND SINGH INDRAPRASTHA UNIVERSITY
(A State University established by the Govt. of NCT of Delhi)
Accredited as NAAC A++ Grade
PREFERENCE SHEET FOR THE ACADEMIC SESSION 2024-25
Name of the Programme: ___________________________________________________________
Name: Mr/Ms/Mrs. ________________________________________________________________
Address:__________________________________________________________________________________
___________________________________________PIN: __________________________
Telephone No. (with STD Code): ________________________Mob: _________________________
E-mail Address: _______________________NLT/CET/CUET Application No.. ________________
Category: ______________________ Region_______.
Give preference in order of your Priority:
S.No. Name of the College/Institute Programme/Branch
1. ____________________________ ________________________
2. ____________________________ ________________________
3. ____________________________ ________________________
4. ____________________________ ________________________
5. ____________________________ ________________________
6. ____________________________ ________________________
7. ____________________________ ________________________
8. ____________________________ ________________________
9. ____________________________ ________________________
Date : _________________ (Signature of the Candidate)
(Counter Signature of Parent/Guardian)
Note : The preference sheet is valid only for one particular counselling not for all round of counselling & waiting
list. The Candidate will fill up separate preference sheet in separate counselling.
ADMISSION BROCHURE FOR GRADUATE PROGRAMMES 2024-25 Page 19
