(REGISTRATION FORM)

Programme Enrolled
[Link]. (Agri) (Hons./Hons. with Research)
For
Academic Session 2024-2028
Admission Category NS
Full Name of the
KRITI RAJ
Student
Father's Name VINAY KUMAR
Father's Mobile No
Father's Occupation Not Alive
Mother's Name USHA DEVI
Mother's Mobile No 919229022440
Mother's Occupation
Nationality Indian
Date of Birth 30/04/2004
Gender Male
Category GEN
Emergency Contact
7488346800
No

Correspondence Address
WARD NO.21, NIRALA NAGAR, NEAR PRASHANT AAVA, RATANPUR,
Address
BEGUSARAI SADAR
City BEGUSARAI
State Bihar
Country India
Pin 851101
Tel 6378552781
Fax
Mobile 6378552781
Email kritirajsingh1729@[Link]
Permanent Address [Address of Parents]

WARD NO.21, NIRALA NAGAR, NEAR PRASHANT AAVA, RATANPUR,

Address
BEGUSARAI SADAR
City BEGUSARAI
State BIHAR
Country INDIA

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 Pin 851101
Tel.
Fax
Local Guardian(s) to be contacted in emergency
Full LG Name NA
Address NA
City NA
State NA
Pin NA
Tel. NA
Mobile No NA
Email NA

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 Place of stay during this Semester (Non-Hostellers) NA
Address NA
City NA
Pin NA
Telephone NA
Mobile NA
Details of educational Qualification(from high School onwards)
Name of
Year of
Qualifying School/College Board/University Subjects/Stream Percentage Class/Divison/Grade
Passing
Exam
Xth 2020 ICSE ICSE PCM 86.20 86.20
ST PAUL
XIIth 2022 ISC SCIENCE 68.50 68.50
SCHOOL

Any type of sickness that you are prone to and the line of treatment
Any particular Doctor to be contacted in case of your sickness

Full Dr Name
Address
City
State
Pin
Tel.
Mobile No
Email
Your Blood Group A+ve
Upload Signature

Verify Contact Details

User Type Mobile No Alternate Contact No. Email-Id

Single Mother 9241939811 +91 9229022440 Kritirajsingh1702@[Link]
Student 6378552781 Kritirajsingh1729@[Link]

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 UNDERTAKING

I hereby solemnly affirm and declare that the information made and furnished by me in the Registration-
cum-Enrollment Form is true and correct. Further, I am being admitted to the above stated programme
entirely on my request and I agree to abide by all the rules and regulations of the Institution / University
which I have read and understood. I was given opportunity to clarify any doubts I had and I shall not hold the
Institution / University responsible for any gaps in my understanding about the same. In the event of
suppression or distortion of any fact like educational qualification, nationality etc. made in the Registration-
cum-Enrollment Form, I understand that my admission is liable to be cancelled.

I have full knowledge of the fact that in case my attendance in any course is below than the required
attendance as per University Policy/relevant Regulatory Body, whichever is higher, I will be debarred from
appearing in examination of the course(s). I shall abide by the attendance rules of the University/relevant
Statutory Body, whichever are higher, and have understood that ONLY physical presence/online active
presence in the class will be considered as attendance. I have also understood the importance of marks
associated with attendance.

I have uploaded/submitted all requisite documents which are to be verified by the Institution. I have gone
through the rules of provisional registration and fully understand that in the event of my failure to submit to
the Institution / University, appropriate documentary proof of my meeting the eligibility requirement as
specified for my programme of study, my admission to Amity University Uttar Pradesh will be cancelled

Verified that the contents of this undertaking are true to the best of my knowledge and nothing which has
been stated is false and nothing has been concealed or misstated therein. I understand and agree to the above

Date : 23/09/2024

UNDERTAKING BY STUDENT
I, Mr KRITI RAJ son/daughter (Mother’s name) USHA DEVI R/o WARD NO.21, NIRALA NAGAR,
NEAR PRASHANT AAVA, RATANPUR, BEGUSARAI SADARBEGUSARAI Bihar India date of birth
30/04/2004, have taken admission/am presently studying in (Programme of study) [Link]. (Agriculture)
(Honours/Honours with Research) (Name of Institute/School/College) Amity Institute of Organic
Agriculture, Amity University Uttar Pradesh (hereinafter referred as "AUUP") , Campus Noida, enrolled in

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 the Academic Year 2024-2025, bearing Provisional Enrolment Number A014176924036, hereby affirm that I
have gone through the academic requirements of the programme that I have enrolled for and I have fully
understood that during the said programme the Institute/University shall arrange activities beyond class
rooms requiring travels within and outside the country, such as military training camps, industrial visits,
educational tours, field work, seminars, conferences, workshops, quiz/technical competition, cultural
programs, sports, training programmes (including adventure training), to present research papers and such
other curricular, co-curricular activities and extra-curricular activities. I shall observe strict discipline and
follow the regulations and other instructions of the Faculty/Supervisor and other authorities as a student of
AUUP while attending academic and other sessions, student engagement activities and events during my
academic programme, on campus and online, and while staying in the hostel.

I hereby declare that no criminal case is pending or contemplated against me in any Court of Law and I
declare that if anything contrary is found, I shall be solely responsible for the consequences arising therefrom
including cancellation of my admission/expulsion from Amity University Uttar Pradesh.

I hereby irrevocably undertake that:

1. I have gone through the rules, regulations and guidelines about academics, examination, hostel,
discipline, military training camp, sports facilities (including swimming pool), tours and all other
activities, as notified by the AUUP . I fully understand that all these notifications and such other
guidelines and norms as may be notified by AUUP from time to time are to be followed by me in true
spirit during my entire tenure with the University.
2. I shall not indulge in any unlawful activities and shall not violate the law of land, including
Government of India Acts/Laws and Regulations of statutory bodies pertaining to Narcotics, Alcohol
and other psychotropic substances and any directives of the University that may be issued from time to
time. If found guilty of the purchase, possession, use, consumption, sale, distribution or storage of any
alcoholic beverage, controlled substance, smoking or illegal drug on university campus, hostels,
training sites and at all University sponsored student events, conferences and activities actively or
passively, or being part of a conspiracy to promote such activities on the University campus, I am
liable for punishment without prejudice to any other criminal action that may be taken against me
under any penal law or any law at the time being in force.
3. I shall not do anything which may cause any injury or damage to me or to any other person. I
understand that I should not be entering certain areas individually or in a group within the campus,
including in the hostels, which are notified verbally or in writing as ‘out of bound.’
4. I affirm that I have taken the required immunization precautions and I am not suffering from any
communicable diseases, including COVID-19. I also affirm that I am not suffering from any serious
health illness, including mental illness. (I will inform separately to the University if I have/am
suffered/suffering from any communicable disease or mental illness). I will strictly and practically
follow the guidelines of Government of India for COVID-19 while I am in the campus in true letter
and spirit- will wear a mask; will carry my personal sanitizer bottle; will be maintaining social
distancing while interacting with others etc.
5. I have gone through AUUP Regulations on “Maintenance of Discipline among students”.
Further, if I am found to be involved in any indiscipline activity/ies, I shall be solely responsible for the
consequences arising therefrom including cancellation of my admission/expulsion from Amity
University Uttar Pradesh.
6. I shall not do anything wrong and or conduct myself in a manner which may bring disrepute to Amity
University. I will not use Social Media for cyber bullying, disclosing private information of others,
harassment, damaging the reputation and image of others, including Amity University and its
Foundation. I will not use name of Amity University in my personal email-ids.

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 7. I shall keep my personnel belongings, passport, visa and travelling documents with full security and
not hold AUUP responsible for their loss or damage or ask for any compensation whatsoever.
8. That I will comply with AUUP ’s internet use policy which requires that I comply with all applicable
Government of India &/or Uttar Pradesh State Government &/or International laws pertaining to
copyright. That I understand that use of Amity University internet resources for unauthorized
downloading or distribution of copyrighted materials is forbidden and is against the law. If I am
accused of copyright violation or infringement, then I will be required to resolve matters on my own
without involvement of AUUP . That I understand that apart from the aforesaid legal actions,
disciplinary action including loss of use of the AUUP information technology systems up to and
including expulsion from the Hostel/University could result from violations of this policy.
9. I have thoroughly read and understood the Policy Guidelines for Information Security of Amity
University Uttar Pradesh. and Information Technology Act 2000 and amendments thereto. I agree to
comply with the said policy. I understand that if I violate any section of the policy or whole policy, I
will be subject to legal and disciplinary action.
10. I further affirm that I have taken the necessary Insurance Policy and I shall keep Amity University
indemnified and shall hold AUUP and its parent body, the Foundation and their employees/officials
harmless from every type of mishaps, unfortunate incident/accident, loss or damage(s) which may arise
out of any of such activities aforesaid stated in para 1 to 9.
11. I will inform and ensure updation in the record(s) of the University about any change in my or my
parents & guardians permanent/ correspondence/PG address or Telephone no./Mobile No. / E-mail etc.
at any point of time.
12. Further, I undertake the responsibility of full compensation if found guilty of any of my actions that
may have caused damages to anyone and/or the University.
13. I have been provisionally admitted to the above programme of study entirely on my request whereby I
went through the admission process. I am being allowed to attend the Orientation Programme
provisionally, subject to meeting laid down eligibility criteria of the said programme of study of Amity
University Uttar Pradesh. in which I have sought admission. I understand that if found ineligible for
the programme, my admission will be cancelled by the Institution/University and the fee forfeited.

I am agreeing to this Undertaking with due permission of my parents who have given concurrence/consent to
my participation in all such activities / tour programmes stated herein above.
This Undertaking shall remain valid during the entire tenure of the programme in AUUP for which I have
enrolled myself or till the last day of my pursuing the said programme of study in AUUP , whichever period
is applicable.
Verified that the contents of this undertaking are true to the best of my knowledge and no part of the
undertaking is false and nothing has been concealed or misstated therein.

I understand and agree to the above.

Date : 23/09/2024 .

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 ONLINE AFFIDAVIT BY THE STUDENT/ SCHOLAR CONCERNING
REGULATIONS DIRECTIVE FOR BANNING RAGGING AND ANTI-RAGGING
MEASURES

I, Mr KRITI RAJ , 12611902/ A014176924036 / [Link]. (Agri) (Hons./Hons. with Research) (Full name of
student with admission / registration / enrolment number/programme) s/o - d/o Mr. / Mrs. / Ms.
(Mother’s name) USHA DEVI

1. having been admitted to Amity Institute of Organic Agriculture (name of the Institution), Amity
University Uttar Pradesh , have received, gone through and fully understood the Amity University
Regulations/Directive for Banning Ragging and Anti-Ragging Measures in accordance with the Uttar
Pradesh Prohibition of Ragging in Educational Institutions Act, 2010 and UGC Regulations on curbing
the menace of Ragging in Higher Educational Institutions, notified in the Gazette of India, dated July
4, 2009.
2. I have, in particular, perused the Regulations and am aware as to what constitutes ragging
3. I have also, in particular, perused the provisions of UGC Regulations and 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 abetting
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 these
Regulations, whether on campus or off campus or online.
b. I will not participate in or abet or propagate through any act of commission or omission that may
be constituted as ragging under these Regulations, whether on campus or off campus or online.
5. I hereby affirm that, if found guilty of ragging, I am liable for punishment according to these
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 institution in the
country on account of being found guilty of, abetting or being part of a conspiracy to promote ragging
and further affirm that, in case the declaration is found to be untrue, I am aware that my admission is
liable to be cancelled
7. I or my parents shall not hold the University or any of its officials liable for any loss (s), damage (s)
and shall not claim any compensation from the University or its office bearers

Declared and verified that the contents/statements of this affidavit are true to the best of my knowledge and
no part of this affidavit is false and nothing has been concealed or misstated therein.

Declared and Verified at (Place)

WARD NO.21, NIRALA NAGAR, NEAR PRASHANT AAVA, RATANPUR, BEGUSARAI SADAR
BEGUSARAI BIHAR 851101

Date : - 23/09/2024

I have read, understood and agree to the above.

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 ONLINE AFFIDAVIT BY THE PARENT/ GUARDIAN CONCERNING
REGULATIONS DIRECTIVE FOR BANNING RAGGING AND ANTI-RAGGING
MEASURES

I, (Mother’s name) USHA DEVI f/o - m/o - g/o of (full name of student with admission/registration /
enrolment number) Mr KRITI RAJ , 12611902/ A014176924036 [Link]. (Agri) (Hons./Hons. with Research)

1. whose ward is admitted toAmity Institute of Organic Agriculture (name of the Institution), Amity
University Uttar Pradesh
2. I have, in particular, perused the Regulations and am aware as to what constitutes ragging.
3. I have also, in particular, perused the provisions of UGC 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
abetting 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 these
Regulations, whether on campus or off campus or online.
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 these Regulations, whether on campus or off campus or
online.
5. I hereby affirm that, if found guilty of ragging, my ward is liable for punishment according to these
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, abetting or being part of a conspiracy to promote
ragging and further affirm that, in case the declaration is found to be untrue, I am aware that the
admission of my ward is liable to be cancelled.

Declared and Verified that the contents/statements of this affidavit are true to the best of my knowledge and
no part of this affidavit is false and nothing has been concealed or misstated therein.

Declared and Verified at (Place)

WARD NO.21, NIRALA NAGAR, NEAR PRASHANT AAVA, RATANPUR, BEGUSARAI SADAR
BEGUSARAI BIHAR 851101

Date : - 23/09/2024

I have read, understood and agree to the above.

ONLINE SUBMISSION OF INDEMNITY BOND BY PARENTS.

{AT THE MOMENT THIS INDEMNITY BOND IS TO BE ACCEPTED ONLINE.
BUT SIGNED ORIGINAL ON RS.100/- NON-JUDICIAL STAMP PAPER (DULY
NOTARIZED) TO BE SUBMITTED AT THE INSTITUTION ON THE FIRST DAY
OF REPORTING AT THE UNIVERSITY.}

I, (Mother’s name) USHA DEVI R/o (Permanent Address) WARD NO.21, NIRALA NAGAR, NEAR
PRASHANT AAVA, RATANPUR, BEGUSARAI SADAR BEGUSARAI BIHAR 851101 father / mother of

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 Mr. / Ms (Student’s name) Mr KRITI RAJ hereby affirm that my son / daughter has taken admission in
(Programme’s name) [Link]. (Agri) (Hons./Hons. with Research) of (Name of Institution/School/College)
Amity Institute of Organic Agriculture, Amity University Uttar Pradesh, Noida Campus in the current
Academic Year 2024-2025, bearing Enrolment number A014176924036.

I hereby declare that no criminal case is pending or contemplated against my son/daughter in any Court of
Law and I declare that if anything contrary is found, I and my son/daughter shall be solely responsible for the
consequences arising therefrom including cancellation of my son’s/daughter’s admission/expulsion from
Amity University Uttar Pradesh .

In addition, I affirm that I & my ward are aware of the Government of India Acts/Laws/Regulations of
statutory bodies with respect to Ragging, Narcotics, Alcohol and other psychotropic substances, Information
Technology Act 2000 and amendments thereto, and the same has been clarified by me to my ward.

Further, I have understood that my son/daughter shall be required to participate in all activities beyond class
rooms which the Institute/University shall arrange, requiring travels within and outside the country, such as,
military training camps (including adventure training), industrial visits, educational tours, field work,
seminars, conferences, workshops, quiz/technical competition, cultural programs, sports, training programs,
to present research papers and such other curricular, co-curricular and extra-curricular activities.

I hereby affirm that I have gone through the rules, regulations and guidelines with regard to academics,
examination, hostel, discipline, military training camp, sports facilities (including swimming pool), tours and
all other activities, as notified by the Amity University Uttar Pradesh . I fully understand that all these
notifications and such other guidelines and norms, as may be notified by Amity University Uttar Pradesh ,
Government of India and statutory bodies from time to time for attending academic and other sessions,
student engagement activities and events on campus and online and while staying in the hostel are to be
followed by my ward in true spirit, during entire tenure of my ward with the University.

My ward is fully responsible for his/her learning and career. I will keep track of my ward’s attendance in all
the courses during the semesters through Amizone using the password collected from the University, and am
fully responsible for his/her actions. I have understood the attendance rules and if my ward does not attend
classes and his/her attendance is below than the required attendance as per University Policy/relevant
Regulatory Body, whichever is higher, my ward will be debarred from appearing in examination of course(s).

I affirm that my ward has taken the required immunization, including for COVID-19 and he/she is not
suffering from any communicable diseases. I also affirm that my ward is not suffering from any serious
health illness, including mental illness. In case my ward is suffering from any illness, I would inform the
Head of Institution (HoI) with complete details before commencement of Academic Session. The decision of
the University will be acceptable to me and my ward.

I further affirm that I shall keep the Amity University indemnified and shall hold Amity University Uttar
Pradesh and its parent body, the Foundation and their employees/officials harmless, from every type of
mishaps, unfortunate incident/accident, loss or damage(s) which may arise out of any of such activities
aforesaid stated.

Further I shall indemnify Amity University Uttar Pradesh and its parent body, the Foundation and their
employees/officials against any loss and/or damages caused due to any undesirable action on the part of my
son/daughter and any admissible claims arising out of such actions.

This Indemnity Bond shall remain valid during the entire tenure of the programme in Amity University Uttar

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 Pradesh for which my ward has enrolled himself /herself or till the last day of my ward pursuing the said
programme of study in Amity University, whichever period is applicable.

Date : - 23/09/2024

I have read, understood and agree to the above.

Date______________________
Place______________________
(Signature of Student)
Office Seal
(Name & Signature of the Verifying Faculty)

Date______________________

For official use

Enrolment no.
allotted

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 Date______________________
Place______________________
(Signature of Authorised Officer)

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