Professional Documents
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Annexure -VII
FORM 7
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Annexure VIII
FORM 8
FORMAT FOR MEDICAL CERTIFICATE
(TO BE OBTAINED FROM A CHIEF MEDICAL OFFICER OF DISTRICT)
L.T. M.I.
Height Weight Chest Abdomen
History Operation Kocks Colics BP
Seizures Asthma Piles Diabetes
E Pulse Tonsil DNS Hernia
X
A
M Pallor L Nodes CSOM Hydrocele
I
N
A Cardiovascular CNS
T
I Respiratory GIT
O
N Genitourinary Others
Is the candidate physically handicapped : Yes/No
If yes. Type of handicap (Please tick) : Type-I: One leg defective or missing
Type-II: One hand defective or missing
Type-III: One hand and one leg defective
Any other type of handicap (Please specify) :
Any other fnding:
Final result. (Fit/Unft) . Based on the medical
standards given in Appendix III of the Prospectus for the purpose of Admission.
Signature of Candidate Signature of Chief Medical Ofcer
(with ofcial stamp) Date:
Annexure IX
ANTI-RAGGING AFFIDAVIT BY THE STUDENT
1) (full name of student with admission/registration/enrolment number) S/o D/o Mr./
Mrs./Ms. ___________________________________________ , having been admited to
(name of the institution) , have received a copy of the UGC Regulations on Curbing
the Menace of Ragging in Higher Educational Institutions, 2009, (hereinafer 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 con-
stitutes ragging.
3) I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and I 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 abeting 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 behaviour 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 afrm 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 in-
stitution in the country on account of being found guilty of, abeting or being part of
a conspiracy to promote, ragging; and further afrm 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:
VERIFICATION
Verifed that the contents of this afdavit are true to the best of my knowledge and no part
of the afdavit is false and nothing has been concealed or misstated therein. Verifed at
(place) on this the (day) of (month) , (year ).
________________
Signature of deponent
Solemnly afrmed and signed in my presence on this the (day) of (month), (year ) afer
reading the contents of this afdavit.
OATH COMMISSIONER
ANTI-RAGGING AFFIDAVIT BY PARENTS/GUARDIAN
1) Mr./Mrs./Ms. _____________________________________________________ (full name
of parent/guardian) father/mother/guardian of , (full name of student with admission/
registration/enrolment number) , having been admited to ____(name of the institution)
, have received a copy of the UGC Regulations on Curbing the Menace of Ragging in
Higher Educational Institutions, 2009, (hereinafer 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 7 and clause 9.1 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 abeting 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 behaviour 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 afrm 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, abeting or being
part of a conspiracy to promote, ragging; and further afrm 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
Verifed that the contents of this afdavit are true to the best of my knowledge and no part
of the afdavit is false and nothing has been concealed or misstated therein. Verifed at
(place) on this the (day) of (month) , (year ).
________________
Signature of deponent
Solemnly afrmed and signed in my presence on this the (day) of (month), (year) afer
reading the contents of this afdavit.
OATH COMMISSIONER
17. INSTRUCTIONS FOR CANDIDATES FOR FILLING THE APPLICATION FORM
Please read the following Instructions carefully before flling the Application Form
1. Fill the Application Form in ENGLISH in legible manner in applicants own handwriting
using Black Ball-Point Pen.
2. All entries in the boxes must be made only in CAPITAL LETTERS.
3. Please afx a recent Passport size (3.5 x 4.5) colour photograph in the appropriate space
provided. The photograph should be self atested.
4. Tick ( ) the relevant box wherever provided.
5. The Candidate should write his/her name in the order as entered in his/her qualifying
examination Certifcate/ Mark sheet.
6. Write the name of Guardian, if father is not alive.
7. The Date of Birth must be as recorded in the High School/ School Leaving Certifcate.
8. Please write your full mailing and permanent address with PIN CODE., Telephone No. and
email address, if any.
9. Please do not fll in place(s) meant for Ofce use.
10. The Candidates should refer to Section 9.1 of the Prospectus regarding Fee details. The
details of the Bank Draf/ Cash receipt should be entered at the appropriate place. At the
back of of the Bank Draf, Name, and address of the Candidate must be writen.
11. An Incomplete or Illegible Application Form will be rejected.
12. Providing of false and inaccurate information will result in cancellation of admission.
13. Do not enclose any original copy of degree or certifcate with the Application Form.
Bring original and atested copies of degrees/mark-sheets/certifcates, etc. at the time of
Counseling.
14. 14. Acknowledgement Card: One printed Acknowledgement Card is enclosed with the
Application Form which should be detached and stapled with the Application Form by the
candidate. The candidate is required to fll all the columns provided in the Acknowledgement
Card.
15. Please atach Marks Sheet of Qualifying exam.
16. Please enclose TWO (stamped) self-addressed envelopes (10x25 cm) along with the
Application Form.
17. Mail completed Application Form to the Coordinator of Admission, Doon University,
Kedarpur, Ajabpur P.O., Dehradun248001, Utarakhand, India.
18. The Candidates appearing in the qualifying exam will be allowed to sit in the Entrance Test
provisionally subject to fulfllment of qualifying requirements at the time of admission,
they must however submit the marks sheet of the last exam passed.
19. Last date for receiving completed Application Form: May 14, 2011, with late fee of Rs100
upto 21 May, 2011. The University shall not be responsible for any postal delay or non-
delivery of flled in Application form to the University before the due date or receipt of
Admit Card by the candidate.
20. List of examination centers are (1) Dehradun (2) Srinagar (3) Delhi (4) Haldwani (5) Almora
(6) Lucknow (7) Chandigarh (8) Shillong (9) Jorhat (10) Kolkata (11) Bhopal (12) Guwahati.
The University reserves its right to change/cancel any of the above centers of Admission
test at its discretion. The examination center mentioned in the admit cards will be fnal.
1. About the University 2
2. Schools and Programmes of Study 5
3. Academic Programme/Courses/Curriculum 11
4. Assesmenmt/Evaluation of Academic Performance 15
5. Academic Calendar 17
6. Reservation Policy 18
7. Admission 19
8. Entrance Test 23
9. Payment of Admission and Other Fees 25
10. Registratiion for courses 28
11. Financial Assistance 28
12. Anti Ragging policy of the University 29
13. Hostel Facilities 30
14. Medical aid on campus 30
15. Extracurricular Activities/Games and Sports/
Cultural Activities 30
16. Format of form for conduct, reservation,
domicile status and medical certifcates 31
17. Instructions for Candidates for flling the
Application Form for admission 40
18. Application Form for admission 41
19. Registration Form 43
20. Instructions for Candidate 44
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