DEED OF UNDERTAKING
I, Shri/Smt._____________________________________________________________________________________________
Age
about________________
Years,
Occupation____________________
________________________Residing at
do hereby given an undertaking as under:1)
That
I
have
passed
Xth
std./XIth
School)______________________________________ __
std.
Examination
_______Education,
through
(Name
of
the
_________________________________________________________________________________________________________
is situated in Taluka _________________________ Dist. __________________________ State_____________________________
2)
3)
i)
ii)
iii)
iv)
v)
vi)
4)
5)
6)
7)
8)
That
I
am
desires
to
take
admission
in
Std.
XI/XII
in
Jr.
College(Name
School)______________________________________________
______________________________________________for the Academic Year 201 - 201
That while taking admission, I am required to furnish following documents.
Certificate in the prescribed Appendix A (for Candidate coming from outside India)
Statement of Marks of the public Examination / Statements of marks of std, XIth Examinations of the
Junior College (Home Exam).
Passing Certificate of the last public Examination.
School leaving Certificate/ Transfer Certificate.
Migration Certificate in Original.
Report of verification (Pvt. Student only)
of
the
That I am also aware that my admission, is provisional and that the Jr. College shall have every right to access
independently, the truthfulness and correctness of the documents mentioned at Serial Number (3) of this
undertaking. That in the event, if it is subsequently found out by the Jr. College / Board that the particulars
furnished in the admission form or the documents furnished while seeking admission are false and fabricated, in
that event Jr. College authorities will have right to take action against me, including right to cancel the admission.
I am fully aware of the fact that the Jr. College has given me provisional admission subject to grant of eligibility
certificate, my admission to the Jr. College by the Mumbai Divisional Board, Vashi, Navi Mumbai 400703 of
Maharashtra State Board of Secondary and Higher Secondary Education having its Head Office situated at
Bhamburda Shivajinagar, pune 411004.
In case if the Divisional Board rejects my application, submitted through the Head of the Jr. College for grant of
Eligibility Certificate , my admission to the Jr. College shall stand automatically cancelled.
In case if the Divisional Board grants me Eligibility Certificate with instruction to furnish certain documents within
stipulated period, I here by undertake to fulfill the requirement within the stipulated time limit.
I am aware of the fact that, in case, if I fail to furnish the required documents within the stipulated time I shall not
be eligible for admission in the Jr. College and as such my admission shall stand automatically cancelled.
That I have read the contents of the undertaking has properly understood the same and in
witness whereof had signed on this Deed of Undertaking on this day
of................................201
at (Place)......................
__________________________________
________________________________
(Signature of Guardian or Local Guardian)
and name of the student)
(Signature