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APPLICATION FORM

Course
Birthday
Day
Month
Year
Gender
Male
Female
Prefer not to say
Marital Status
Married
Single
Educational Qualification

10th Class

12th Class

Physics

Chemistry

Biology

English

Need hostel facility
Yes
No
Details of registration fee payment

Application fee INR 1000/- (non-refundable) should be paid through the Bank.

Bank  : Canara Bank

Branch  : Sasthamangalam

IFSC  : CNRB0000821

A/C No  : 0821101007005

A/C name  : President, Sri Ramakrishna Ashrama Charitable Hospital

DECLARATION BY THE APPLICANT

JOINT DECLARATION BY THE PARENT/GUARDIAN

AND THE APPLICANT

I hereby solemnly and sincerely affirm, That the statements made and information furnished in my daughter’s /son’s/ ward’s application as also in all the enclosures thereto submitted by her/him are true, should it however be found that any information furnished there in is untrue in material particulars, I realize that I am liable to criminal prosecution and I also agree to the forfeiture of the seat in the institution.


That my son/daughter/ward would conform strictly to all rules and regulations in force now or which may be introduced in the institution hereafter and that I realize that breach of discipline and rules on my daughter’s / son’s/ ward’s part would entail summarily forfeiture of his/ her seat in the institution.


That I am aware that if my son / daughter/ ward does not put in a minimum percentage of attendance during the year/semester, my son; daughter / ward will not be eligible to appear for the University Examination.


That we are aware of the Legislation on prevention of Ragging and that he/she will not indulge in any act amounting to ragging and not use mobile phones inside the campus.


That I am aware that if my son/daughter/ward does not show consistent progress of marks in the day to day valuation of his/her work and progress he/she will not be sent up for the University examination.


That in case of my son / daughter/ward’s progress in studies is uniformly poor in the Institution his/her studies are liable to be terminated and issue of Transfer Certificate.


That I am aware that my son/daughter /ward as admitted in the hostel he/she will strictly abide by the rules and regulations in force in the hostel and that any breach of discipline or rules or any unruly conduct or undesirable activities will be summarily dealt with by forfeiture of seat both in the hostel and in the institution in addition to such other proceedings that may be taken against him/her.

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