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Noida International University: Pre-Registration Form

This document contains a pre-registration form for Noida International University. The form collects personal details such as name, date of birth, contact information, qualifications, and other details from prospective students. It also includes declarations by the student and parent/guardian agreeing to abide by university rules and regulations. The form collects important details to process applications from students interested in taking courses at Noida International University.

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mliswme
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© Attribution Non-Commercial (BY-NC)
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60 views

Noida International University: Pre-Registration Form

This document contains a pre-registration form for Noida International University. The form collects personal details such as name, date of birth, contact information, qualifications, and other details from prospective students. It also includes declarations by the student and parent/guardian agreeing to abide by university rules and regulations. The form collects important details to process applications from students interested in taking courses at Noida International University.

Uploaded by

mliswme
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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NOIDA INTERNATIONAL UNIVERSITY Affix Your Latest

Passport Size

PRE- REGISTRATION FORM Photo Here

INR 500/-
1. Course Name

2. School/Department/Institute

3. Session Semester
4. Name of Candidate Mr./Ms

5. Father’s/Husband’s Name
6. Mother’s Name

7. Date of Birth (DD/MM/YY) Birth Place Blood Group

8. Nationality Resident Indian Non-Resident Indian Foreign Passport Holder From

9. Category (If Resident Indian) SC ST OBC General

10. Domicile of U.P YES NO

11. Correspondence Address

Telephone No: Mobile No: Email:

12. Permanent Address

Telephone No: Mobile No: Email:

13. Gender Male Female

14. Is your family income below INR 1 Lac per annum? YES NO

15. Are you physically challenged? YES NO

If yes, please specify type of disability


16. Qualification
Name of the Examination Board/University Yr. of Passing Subject School/College Attendant % Age/Div
th
X /High School/Equivalent
XIIth /Intermediate/Equivalent
Graduation
Post Graduation

17. Achievement/Awards 18. Extra curricular activities


(Attached an extra sheet, if needed) (Attached an extra sheet, if needed)
19. Will you be requiring Accommodation Assistance? YES NO

20. Will you be requiring Transport Facility? YES NO

21.Payment Details Mode: Cash / DD DD No. DD Date Drawn on (Bank Name)


DECLARATION
I hereby certify that the information given in the application form is complete and true to the best of my knowledge. I pledge to abide by the
all Rules and Regulations of Noida University. I understand and agree that misrepresentation or concealment of facts or any contravention or
breach of rules of regulations will justify the denial of admission/ cancellation of admission/expulsion and/ or initiation of proceedings under
appropriate sections of the Indian Penal Code. I have read and do hereby agree to the terms and conditions.
Name of the Candidate Signature Date
Parent/Guardian’s Endorsement

‘ I agree with the above and take full responsibility of my son/ daughter/ ward and to pay all his / her dues till the end of the course’
Parent/Guardian’s Name
Signature Place Date
TO BE ENTERED BY NOIDA UNIVERSITY OFFICE
Form no ..................................... Date ..................................... Reference .....................................
Corporate Office:309, Jaipuria Plaza, Sector-26 , Noida,U.P, INDIA Ph.:0120-4619999,+91-9310095560-63 Email:[email protected] www.noidauniversity.org

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