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Application Form

This document is an application form for admission to North East Christian University, detailing personal information required from the applicant, including course selection, contact details, and educational background. It includes declarations from the student and their guardian regarding the authenticity of the information provided and adherence to university regulations. The form emphasizes the importance of maintaining a respectful environment on campus and the consequences of failing to submit necessary documents.

Uploaded by

Sunil Rawat
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135 views2 pages

Application Form

This document is an application form for admission to North East Christian University, detailing personal information required from the applicant, including course selection, contact details, and educational background. It includes declarations from the student and their guardian regarding the authenticity of the information provided and adherence to university regulations. The form emphasizes the importance of maintaining a respectful environment on campus and the consequences of failing to submit necessary documents.

Uploaded by

Sunil Rawat
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

North East Christian University

(Established under the North East Christian University Act 2012 and U/S 2 (f) of UGC Act 1956.)
Burma Camp East Block, Dimapur- 797112 : Nagaland

APPLICATION FORM

1. Name of Course Applied.


2. Course Code.

Paste recent
3. Level of the Course PG UG PG Diploma Diploma Certificate Passport Size
Photograph. It will
be printed on I Card

4. Student’s Name

Email…………………………………………………………. Phone No.

5. Father’s Name

Occupation: …………………………………………………………………………………………………………………………………………………………………………..

Email……………………………………………………….…………………………. Phone No.

6. Mother’s Name

Occupation: ………………………………………………………………………………………………………………………………………………………..………………..

Email……………………………………………………….…………………………. Phone No.

7. Address for Correspondence ………………………………………………………………………………………………………………….…………………………..

................................................................................................................................................................................................

……………………………………………………………………………………………………………….………… Pin Code

8. Date of Birth Date Month Year

9.Gender Male Female

10. Category GEN OBC SC ST MIN


11. Religion …………………………………………………………………..

12. State of Domicile. Nagaland Other Name of State ……………………………….

13. Nationality.

14. Aadhar no. (if any)

Details of the last Examination passed:-


Exam Passed Board/University Subject Marks Remarks
Obtained Marks Full Marks
10th / Matric

12th / Inter

Graduation

Post-
Graduation
Any Other

DECLARATION
1. That I have carefully gone through the above application form relating to admission and other particulars and filled in the same by
myself without being influenced by any Person/s.
2. That particular provided by me are true and correct to the best of my Knowledge, belief and information.
3. That my Registration may be withdrawn anytime by the University, in the event of my failure to submit the original Migration
form/Transfer certificate from the Board/University that I have last attended within the time as stipulated by the University.
4. That I shall not indulge in any act of Ragging and shall hold the dignity of my follow female students in particular and all the elders
& women in general the University campus in high esteemed.
5. That I, without recourse to any other means, shall apply for the necessary verification of my academic credentials which may include
certificates marksheets, Degrees, Diplomas etc. that I shall acquire from this University during my period of studies or thereafter, any
time, if needed, by submitting my application in prescribed format for the same with requisite fee to be payable for the said purpose
at such time.

……………………………………………
Signature of the Student (Applicant)
DECLARATION BY FATHER/GUARDIAN

I hereby declare that my ward ………………………………………………………. will not indulge in any act of ragging and shall not
cause or cause to do such act/s that may disturb the dignity of any person/s in the campus. Rules and regulation of the university
will be binding on my ward and me.
…………………………………………..
Signature of Father/Guardian

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