Appl. No.

ISC A ffix Pa s s port

s iz e photog ra ph
35 mm x 45 mm size
In Formal Dress with
Tel. +91-80-4012 9105/9439 White Background
Fax. (080) 40129000
www.christuniversity.in

International Students Application Form

(SAARC / AFRICA / ASEAN / OCI / PIO & Other Foreign Nationals)

UG PG
Course / Programme Applied for : .......................................................................

Name of the candidate: .........................................................................................

Name of the candidate as per marks card: Male Female Rural Urban
_____________________________________________________ Sports Person: Yes No
Date of Birth: D D M M Y Y Y Y Differently Abled: Yes No
Place of Birth: _________________________________________ If Yes, (Specify)________________________________________
Country of Birth: ______________________________________ Blood Group: ____________
Nationality: __________________________________________ Phone Details: Country Code: ___________________
Mother Tongue: _____________ Religion: ________________ Area Code:__________ Phone No: _______________________
Mobile No: ___________________________________________
If Christian: Catholic: Non-Catholic: Email: ________________________________________________

Passport Details
Passport No: _________________________________ Passport Issuing Country: ___________________________
Valid up to: ___________________________________ Resident Permit (RP) No (If available): __________________
Student visa : Yes No Medical Certificate: Yes No

Current Address Permanent Address

Address:_____________________________________ Address:____________________________________
____________________________________________ ____________________________________________
____________________________________________ ____________________________________________
City: __________________ State: _______________ City: __________________ State: _______________
Country: _______________ Pin Code: ____________ Country: _______________ Pin Code: ____________

Academic Record
Class Marks
/Degree Institution Attended Board/University State / Country Year % Attempts

10

12

*
* Specify the Bachelors Degree name, e.g. BA, B.Sc, B.Com, BBM, BBA, BE, B.Tech etc

English Proficiency:
English Language Proficiency: Poor Average Good

If good specify : a) Native speaker: b) Studied in English medium: c) TOEFEL/ IELTS Scores:

(Enclose Certificate).

Would you like to join Intensive English Language Course: March – May 2018? Yes No
 Details of Parents

Father's Name: _____________________________ Mother's Name: ______________________________

Qualification: ________________________ Qualification: _________________________

Current Income : ____________________________ Current Income : _____________________________

Income per annum: __________________________ Income per annum: ___________________________

Occupation: ________________________________ Occupation: _________________________________

Educational Background of Siblings
Encircle and write the educational qualification of your Siblings B for Brother, S for Sister,

1. B S _______________ 4. B S ________________
2. B S _______________ 5. B S ________________
3. B S _______________ 6. B S ________________
Guardian Name and Address

Guardian's Name: ___________________________________ Relationship:_________________________________

Address line:____________________________________________________________________________________

_______________________________________________________________________________________________

City: _____________________ State: __________________ Country: ___________________ Pin Code: __________

Phone No: _________________ Mobile No: __________________

How did you know about this course: Advertisement Alumni E-Mail Facebook Friends

Others Poster Relatives School Website

Reasons for Applying: ........................................................................................................................................

........................................................................................................................................................................
UNDERTAKING

I, ___________________________________________________hereby undertake to uphold the Vision, Mission and Core Values of

CHRIST (Deemed to be University). I shall strive to excel in my studies with all ability and shall imbibe the Graduate
Attributes of the University. I hereby declare and confirm that if, a) I do not have at least 85% attendance in each of the Courses
of the programme at the end of each semester and / or, b) I do not live up to the ideals of the University and / or, c) My conduct
is not to the satisfaction of the University and / or, d) I indulge in any behaviour or act that may come under the definition of
ragging and / or, e) I indulge in any act of sexual harassment. Then the University shall have absolute rights to 1) Debar me
from one or more examinations of the University or 2) Detain me from furthering the Course or programme 3) Terminate my
admission with the University by removing my name from the Rolls. I further promise to abide by the rules and regulations of
this University.

I have given this undertaking voluntarily and in full agreement of what is stated therin.

Date:....................Signature of the Parent/Guardian: ................................Signature of the Candidate: ...........................

FOR OFFICE USE ONLY

Fee Amount: ......................................, Challan No: .........................., Date: ............................, Signature of the Official: .................

Admitted Into: ..........................., Date: ..........................., REGISTRAR: ...............................

 STATEMENT OF UNDERSTANDING 
1. I understand and agree that I will fall under SAARC, AFRICA / ASEAN and Other Foreign National Category and the
program fee will be as applicable and binding.

2. I understand and agree that I should send the following documents within 15 working days of receiving this application
form, else the application stands “Rejected”;

a. The Filled in Application Form duly signed by the parent and the candidate

b. Application fee in Demand Draft for US $ 100 or Equivalent in Indian Rupees or copy of the bank transaction certificate for
having transferred US $ 100 or equivalent Indian Rupees to Christ University Account No:

Name of the Bank : The South Indian Bank Limited

Bank Branch & Address: CHRIST (Deemd to be University) Branch, CHRIST (Deemd to be University) Campus, Hosur Road
District: Bengaluru
Pincode: 560029
State: Karnataka
Branch Code Number: 0396
Bank A/C No.: 0396053000015000
MICR code of the Bank: 56005910
SWIFT code: SOININ 55
IFSC Code: SIBL0000396
c. Photocopies of Class 10, Class 12 and Degree Marks Statement (as applicable).

d. 2 passport size (Photo size of 35mm x 45 mm with White background - Standard Indian Passport Format Only) and 2 Stamp
Size photographs. (Write your name and application number & Programme applied for behind the photographs).
e. Copy of Passport and Visa (Mandotry)
3. I understand and agree that on confirming the admission status, all the Original documents mentioned below should be
submitted at the Office of Admissions, during my admission process in Person.

a. Class 10 and Class 12, b. Degree Marks Card (Students Applying for Post Graduate Programmes)

4. I understand that if I have any documents which are pending to be submitted to Office of Admissions, Christ University,
Bangalore, it should be submitted on or before July 15, 2020. Failing to submit the pending documents will be treated as
unsuccessful in the qualifying exam and admission will be cancelled without any claim.

5. I understand the decision of the Admission Committee is final and binding.

6. I agree and understand that CHRIST (Deemd to be University) will cancel my admission, if my qualification related documents
are found fraudulent / misrepresented / falsified /manipulated.

7. I understand the definition of ragging and the penalty of ragging under the Karnataka Education Act, 1983 ( Karnataka Act No.1
of 1995) Section 2 (29) and the Order of Hon’ble Supreme Court of India.

8. I understand and undertake to face disciplinary action/legal proceedings including Cancellation of Admission/Debarring from
examinations, valuation and assessment process/Expulsion from CHRIST (Deemd to be University), if I’m found guilty of any
aspect of ragging.
9. I understand and agree that if I wish to cancel my admission at any given time, I will be entitled for a refund of fee as per the
UGC regulation F.No.6-1(7)/2006(CPP-I). If I am entitled for any refund as per the above regulation, I will report in person to
Office of Admissions, Central Block, CHRIST (Deemd to be University), Bengaluru for the cancellation process.

10. I understand and agree that No Third party/member/parent will be entitled to process the cancellation and receive the fee if
applicable as per Para 9, on behalf of me.

11. I further understand that In case I am not in a position to process the cancellation in person due to any Medical Reasons or for
any other genuine reasons, the candidate should authorize a person (Third Party) with an authorization letter and all other
supporting documents & valid id proof of the (Third Party), to process the cancellation.

12. I understand and agree that the fee as per Para 9 will be refunded only through an account payee cheque favoring the
candidates name and handed over to the candidate only, and will not be refunded by cash
13. I agree that I have understood the attendance rules and regulations of the University and that I will not be allowed to appear
for the exams in case I fall short of attendance/my attendance is below 85% in each subject.

Signature of the Parent: ……................……………………..….. Signature of the Candidate: ……................……………………..…..

Date:……………………… Date:………………………………..