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    Undertaking For Student Eligibility

    Uploaded by

    manohar

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Undertaking For Student Eligibility

    Uploaded by

    manohar
    9 views2 pages

    Original Title

    Undertaking for Student Eligibility

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
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    9 views2 pages

    Undertaking For Student Eligibility

    Uploaded by

    manohar

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    UNDERTAKING

    (For Non-Submission of Leaving / Transfer Certificate and Migration Certificate)

    I solemnly give the following information which is required by Bharati Vidyapeeth (Deemed to be University)
    for enrolling me for _________ Programme under Centre for Distance and Online Education during the
    Academic Year ____________________ I am unable to submit my Leaving / Transfer Certificate and
    Migration Certificate of my previous college / University due to
    ________________________________________________________

    _____________________________________________________________________________________

    Name :
    ______________________________________________________________________________

    Details of Last Qualifying Examination: _____________________________________________________

    (Name of the Examination Passed)

    Special Subject / s : ____________________________________________________________________

    Board / University : ____________________________________________________________________

    Percentage of Marks Obtained : __________________________________________________________

    Year of Passing : _______________________________________________________________________

    *Date of Birth : _____________________________________

    (As recorded on 10th Std.Certificate)

    Present Address : ______________________________________________________________________

    _____________________________________________________________________

    _____________________________________________________________________

    Contact No. : Landline : _________________________________

    Mobile : __________________________________

    Employer’s Name with Address : _____________________________________________________

    (if employed) ___ __________________________________________________

    _____________________________________________________

    Contact No. : (Office) : _____________________________________

    Religion : ________________________________________________________

    *Caste : _________________________________________________________

    I solemnly declare that the above information is true to the best of my knowledge and in case any information
    is found to be false I can be held responsible. I would abide by the decision taken by the competent authority
    of the University of whatever mention is false and it may even lead to the degree being withdrawn. I am
    aware that a legal action can be taken by Bharati Vidyapeeth (Deemed to be University) against me in that
    case.
    I hereby agree that it will be my sole responsibility with regard to the issues cropping up in future because of
    non-submission of Original Leaving / Transfer Certificate and Migration Certificate.

    I am aware that, Bharati Vidyapeeth (Deemed to be University) will not issue Leaving / Transfer Certificate or
    Migration Certificate after completion OR during the Study of Programme.

    Date : Signature of the Student

    Place :

    Signature of Witness (1) : ____________________________

    Name : ____________________________________________

    Contact No. : _______________________________________

    Signature of Witness (2) : ____________________________

    Name : ___________________________________________

    Contact No. : ______________________________________

    NOTE : 1) Undetaking should be notarized on 100/- Rupees Stamp Paper.

    2) *Attach Documentary Proof : 10th Std.Certificate, Caste Certificate if Applicable

    3) This undertaking is not applicable for foreign students.

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