MAHARAJA AGRASEN HIMALAYAN GARHWAL UNIVERSITY UTTARAKHAND (Formerly Himalayan Garhwal University, Uttarakhand) APPLICATION FORM Name of Course Applied. Course Code. Paste recent Level ofthe Course PhD Pre PhD PG | us Passport Size PG Diploma} Student’s Name Diploma{ Certificate Email Photograph. It will be printed on Card PhoneNo, (Linked with Aadhar*) Father's Name OccUpatiON: wevenenan Email Phone No, Mother's Name OCCUPALION: wrnnnmennnnnenrnnnnnnenes Email... Phone No. ‘Address for Correspondence ... Permanent Address snow Pin Code10. a. 12. 1B. 15, 16. a Date of Birth Date | Month | Year Gender Male Female Category GEN ope sc oT MIN Religion State of Domicile. Uttarakhand Other Name of State Nationality. wm COCO Annual Family Income Details of the last Examination passed:- Exam Passed | Board/University | Subject Marks Remarks Obtained Marks [Full Marks 10" / Matric 1257 inter Graduation Post Graduation ‘Any Other: DECLARATION That | 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. ‘That particular provided by me are true and correct to the best of my Knowledge, belief and information. That my Registration may be withdrawn anytime by the University, in the event of my failure to submit the original Migration form/Transfer certificate from the Board/University that | have last attended within the time as stipulated by the University. (This declaration may be ignored, if the applicant has already submitted his/her in original Migration/Transfer certificate with this Application). That registration for the above mentioned course shall be in force only when tuition free paid by Draft/Online is realized in University’s Account. ‘That | have not indulged and shall not indulge in any act of Ragging, Discrimination (Religion, Caste, Sex, Colour etc.) and shall hold the dignity of my University, Department and Faculty and staff in particular and all the elders & women in general the University campus in high esteemed. That | shall keep the University campus clean free from all plastic, elements to save the environment.Signature of the Student (Applicant) DECLARATION BY FATHER/GUARDIAN 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 R OFFICE Ly ‘Admission Granted Waiting Rejected Registration No. Receipt No. Date of Admission os wont Year | course code Admission in-charge’ Registrar Registration No. Course Code Enrollment No. GeFollowing self attested copies of documient enclosing here with. 1, 10% mark sheet from recognized board 2. 12" mark sheet from recognized board 3. 10" pass certificate from recognized board 4, 12" pass certificate from recognized board 5. Graduation Marks Sheet 6. Post Graduation Marks Sheet 7. 4 passport size photographs 8 Aadhar card 9. Anti-ragging Affidavit 10. Domicile (for permanent residents of Uttarakhand) and for claiming Government fat 11, Annual income certificate 12. Transfer certificate / Migration Certificate (Original) 13. Character certificate 14. Proof of entitlement for a particular reservation category (SC/ST/OBC/MIN Certificate) 15. Pre-Qualifying test score card (If any) 16. Medical Fitness Certificate (In Case of any Medical History) 17. Domicile certificate 18. Caste certificate if claiming Government Scholarship 19. Bank account detail for scholarship 20. Copy of passport (for foreign student) 21. Equivalent certificate of foreign Degree/Diploma issued by AIU (Association of Indian Universities, New Delhi) 22. Gap Certificate incase of Gap in Qualifying exam and course opted for admission.