Admission Form Printed on 6/15/2024 7:47:31 PM

CHECK LIST OF THE DOCUMENTS REQUIRED IN HARD FORM FOR APPLICANT

UID : 15BCS1606
Program Name : Bachelor of Engineering - Computer Science & Engineering
Account No. : 11502133
(Common for all categories)
Name Of Documents:- Photocopy of Original Photocopy of Provisional Pending/
Certificate (Website/Internet/ Not Available
(A) Educational # Digilocker copy/ E-Copy)
10th Mark Sheet [ ] [ ] [ ]

12th Mark Sheet [ ] [ ] [ ]

Diploma (Sem./Year) [ ] _____________________ [ ] ____________________ [ ] ___________________

Graduation (Sem./Year) [ ] _____________________ [ ] ____________________ [ ] ___________________

Post-Graduation [ ] _____________________ [ ] ____________________ [ ] ___________________

(Sem./Year)

Other (If Any) (JEE, _______________________________________________________________________

NATA, EWS etc.)

Character Certificate [ ] [ ] [ ]
(Original/Online)

Migration Certificate [ ] [ ] [ ]
(Original/ Online/
Digilocker)

Aadhar Card-Student [ ] [ ] [ ]

Photographs (5)
“professional front face
passport size
photograph with plain
background” Submitted [ ] Pending [ ]
(Preferably same as
uploaded on CUIMS)

Caste Certificate (if

applicable- for applicants
other than Submitted [ ] Pending [ ]
SC/ST of Punjab &
Chandigarh)

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 (B) Required only for SC/ST applicants belonging to state of Punjab and Chandigarh (UT) who are desirous for applying
PMS (provided they fulfil PMS criteria)
Caste Certificate Original Submitted [ ] Pending [ ]

Domicile/ Original Submitted [ ] Pending [ ]

Residence
Certificate

(Not Older than 5 Original Submitted [ ] Pending [ ]

years)
Income
Certificate

Bank Account
Copy Submitted [ ] Pending [ ]

Aadhar Card: Submitted [ ] Pending [ ]

Father

Aadhar Card: Submitted [ ] Pending [ ]

Mother
(C) Additional for International Applicant

Passport Copy/ National ID Card Copy Submitted [ ] Pending [ ]

Admission Employee Name & ECode: Eligible/ Not Eligible/ Prov. Eligible/ Pending Eligibility

Admission Employee Sign with date: Dealing Hand Signature/ ECode:

# All the Educational ORIGINAL for SC/ ST Category for Verification purpose only.

Printed on 6/15/2024 7:47:31 PM

University Information System - By - ERP Division Page 2 of 9

 Admission Form

Student Account No :11502133 Prospectus No : Enquiry No :

Student Personal Detail Admission Process Detail
Gender Male University CHANDIGARH UNIVERSITY
Date Of Birth 07 Dec 1996 Course for Admission BE-CSE:::CS201

Blood Group NA Under Lateral Entry No

Religion NA Semester 1
Migrated No
Name RAVI BHARTI
Country India
Mother's Name GUDDI DEVI
Hostel Facility No
Father's Name RAMESHWAR BHARTI
Transport Facility NA
Category GEN
Transport Route NA
Nationality Indian
Program Fee 3000.00 USD
Annual Income NA Aadhar Card Number NA

From where did you first hear about us: Calling

Student Contact Information

Permanent Address Correspondence Address
#E29212/1/88 NEAR SHANI MANDIR 33 ROAD LUDHIANA #E29212/1/88 NEAR SHANI MANDIR 33 ROAD LUDHIANA

Country India Country India

Pincode 141016 Pincode 141016
City Ludhiana City Ludhiana
District Ludhiana District Ludhiana
State Punjab State Punjab

Type Mobile No Landline No Office LL No Email Id Education Level Occupation

Student 8528866942 NA NA RAVIBHARTI712@GMAIL.COM NA NA

Student Qualification Details

Degree University Board Total M.Obtained CGPA Qualification % Year Main Subjects Status School Name

Student Exam Details

Exam Name Exam Rank Score Passing Year

Counselor Signature Parents/Guardians Signature OR Student Signature

Parminder Kaur (E2184) RAMESHWAR BHARTI RAVI BHARTI (11502133)

CHANDIGARH UNIVERSITY Printed on 6/15/2024 7:47:31 PM

Account No : 11502133 Date for Registration : : Jul 16 2015 1:54PM

Program : BE-CSE:::CS201 Program Fee : : 3000.00 USD

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Did you appear for any National/State ent rance test(s)? Yes / No ......................................................
Mention the Name and Percent Score of the Test you want to be considered: ..........................................................
(Please attach a photocopy of your test score.)
Please mention if you have any achievements in Sports/ Co-curicullar activities at the National/ International/ State Level

_____________________________________________________________________________________________________

DECLARATION BY STUDENT

• I do hereby declare that particulars given in this registration form are complete, correct and true to the best of my knowledge
and belief and nothing has been concealed.
• I understand that my registration is provisional for admission to the University, subject to the fulfillment of eligibility conditions
and verification of documents and the onus of getting these documents verification lies with me.
• I will produce all required original documents on or before 30th June 2015. If I fail to submit required documents on the
stipulated date and fail to pay full fee my admission will stand cancelled
• If at later stage my documents are found to be fake, I will be solely responsible for legal consequence and will not claim any
refund of fee/ seat from the Institute/ University on any account whatsoever.
• I am not suffering from any contagious or chronic disease abd medical fit to study in Chandigarh University .
· I agree to observe and abide by all the rules and regulations (as amended from time to time) of the University
· In respect of course of study, syllabi, scheme of examination, conduct and related matters.
· I undertake not to organize or take part in any strike or demonstration.
· I fully understand that for any violation or infringement of the University rules and regulations, disciplinary action can be taken
against me by the authorities.
· I have not been involved in any criminal offence and no case is pending against me in any court of law
· I have neither indulged in any ragging activity in the past nor will I indulge in ragging directly or indirectly during my stay in the
University.
· I clearly understand that in order to be eligible to appear in any end semester examination, I must have attended not less than
75% of the scheduled lectures of theory as well as practical in each paper as per norms.
· I promise to abide by the rules and regulations of Transport, Hostel of the University as applicable from time to time.
· I promise not to indulge in any use of intoxicant, smoking and drugs, etc.

· The mobile numbers and email id’s mentioned in the Registration form are genuinely mine and of my (Father/ Mother/
Guardian).
· I undertake that my Mobile Number is linked with Aadhar card.

___________________ ___________________________
Student’s Signature Signature of Parent/Guardian

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 Note: Please attach:
I) Photocopies of Detailed Marks Sheets (Graduation, 10+2, Matric, Diploma, Character,
Migration etc. ii) Four Passport size photographs
FOR OFFICE USE ONLY

Step – 1. I have checked the eligibility conditions applicable in the above said course and the candidate agrees to fulfill these
conditions.

(Admission Counselor)

Step – 2. I have received fee amount vide Receipt No. .......................... dated .......................... Amount .......................... from
the student and balance fee .......................... will be paid on or before ...........................

(Admission Incharge)

Step – 3. I have received fee amount vide Receipt No. .......................... dated .......................... Amount ..........................

(Cashier)

Step – 4. The admission has been provisionally approved after verification of original/provisional documents..
Pending documents (if any) ..............................................................

(Registration Branch-Dealing Staff)

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 UNDERTAKING OF CYBER CRIME

I, RAVI BHARTI S/o, D/o RAMESHWAR BHARTI registered for admission in Course Bachelor of Engineering - Computer
Science & Engineering Batch 2015 Sem 1 for academic session 2015-2016 at Chandigarh University, do hereby undertake
that:

1. I am aware that Cyber Crime is strictly prohibited and unlawful act by the law.

2. I will not indulge in any kind of Cyber crime including Cyber-Stalking, Dissemination of Obscene Material , Defamation,
Hacking, Cracking, E-Mail Spoofing, SMS spoofing, Carding, Cheating and Fraud, Child Pornography, Assault by Threat,
Intellectual Property Crimes, Cyber Squatting, Cyber Vandalism, Transmitting Virus, Cyber Trespass, Cyber Terrorism, Cyber
Warfare, Possession of Unauthorized Information.

3. I will not share my user id, password or any digital information with anyone. I will be responsible of any activity done with my
credentials.

4. I am aware that the infringement of the above undertaking makes me liable for disciplinary action as deemed fit by the
University rules including punishment in the form of expulsion from classes, University campus and the hostel.

5. I have fully understood that if I am found guilty of cyber crime then I shall be punished as per the provisions of Section 66-A
of Information Technology Act, 2008 and may be punished with imprisonment up to 3 years alongwith fine under the court of
law.

Date:…………………………… (Signature of Student)

Name……………………………………………

I,…………………………………………………………have carefully read and clearly understood the content of the above
undertaking, I do hereby undertake that I shall be jointly responsible if my son/ward is found indulging in any act of indiscipline
or misconduct or ragging or cyber crime. The University may take any disciplinary action against my son/ward.

(Signature or Parent/Guardian)

Date:…………………………………… Name…………………………………………………….

Relation………………….……………………………..

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 UNDERTAKING FORM MANDATORY TO BE UNDER UGC REGULATIONS ON CURBING THE MENACE OF RAGGING IN
HIGHER EDUCATIONAL INSTITUTIONS, 2009

UNDERTAKING BY THE STUDENT

I, RAVI BHARTI s/o, d/o RAMESHWAR BHARTI has taken admission in course Bachelor of Engineering - Computer
Science & Engineering session 2015-2016 student of Chandigarh University, Gharuan, Mohali, do here undertake on this day
16 month Jul year 2015 the following :-

1. That I have read and understood the directives of the Hon’ble Supreme Court of India on anti ragging and the measures
proposed to be taken in the above references (available on the website “www. cuchd.in”). I have, in particular, perused clause 3
of the Regulations and am aware as to what constitutes ragging.

2. That I understand the meaning of Ragging and know that ragging in any form is a punishable offence and the same is
banned by the Court of law.

3. That I have not been found or charged for my involvement in any kind in any kind of ragging in the past. However, I undertake
to face disciplinary action/legal proceeding including expulsion from the University if the above statement is found to be untrue
or the facts are concealed, at any stage in future. I have also, in particular, perused clause 7 and clause 9.1 of the Regulation
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 aware and undertake that:

a. I will not indulge in any behavior or act that may be constituted as ragging under clause 3 of the Regulations.
b. That I will not participate in or abet or propagate through any act of commission or omission that may be constituted as
ragging under clause 3 of the Regulations.

5. I hereby affirm that, if found guilty of ragging, I am liable for punishment according to clause 9.1 of the 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. That I shall not resort to ragging in any form at any place and shall abide by the rules/laws prescribed by the courts, Govt. of
India and the University authorities for the purpose from time to time.

Signature of Student
I hereby fully endorse the undertaking made by my child/ward.

Signature of Mother/Father and or Guardian

Witness:

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 UNDERTAKING FROM STUDENTS FOR NON SUBMISSION OF DOCUMENTS

(TO BE GIVEN BY CANDIDATES WHOSE RESULT OF QUALIFYING EXAM IS NOT DECLARED OR WHO HAD ANY
COMPARTMENT/ BACKLOG)

“I RAVI BHARTI s/d/o Sh RAMESHWAR BHARTI bearing UID/Account No. 11502133 had taken provisional admission in
Bachelor of Engineering - Computer Science & Engineering Course in the session 2024-2025 do hereby solemnly
undertake that I will produce the proof of passing of my Qualifying examination with the minimum percentage of marks required
on or before 30 Sep 2024, failing which my admission shall stand cancelled.

Dated: ............................ Signature of candidate

Signature of Parent/Guardian

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 CHANDIGARH UNIVERSITY
…
ACKNOWLEDGEMENT SLIP
Account No : 11502133 Date ............................

Received Original documents against temporary Account No. 11502133 pertaining to Mr./ Ms RAVI BHARTI son/ daughter
of Sh RAMESHWAR BHARTI admitted to course Bachelor of Engineering - Computer Science & Engineering
Session: 2024-2025.

Submitted Document: Pending Document:

1. ............................................................................ 1. ..........................................................................

2. ............................................................................ 2. ..........................................................................

3. ............................................................................ 3. ..........................................................................

4. ............................................................................ 4. ............................................................................

5. ............................................................................ 5. ............................................................................

Any Other: .............................................................. Any Other: .............................................................

Name of the Dealing person with E-Code: Parminder Kaur (E2184)

Signature and date : .........................................

CHANDIGARH UNIVERSITY
…
ACKNOWLEDGEMENT SLIP
(Parents Copy)
Account No : 11502133 Date ............................

Received Original documents against temporary Account No. 11502133 pertaining to Mr./ Ms RAVI BHARTI son/
daughter of Sh RAMESHWAR BHARTI admitted to course Bachelor of Engineering - Computer Science &
Engineering Session: 2024-2025.
Submitted Document: Pending Document:

1. ............................................................................ 1. ..........................................................................

2. ............................................................................ 2. ..........................................................................

3. ............................................................................ 3. ..........................................................................

4. ............................................................................ 4. ............................................................................

5. ............................................................................ 5. ............................................................................

Any Other: .............................................................. Any Other: .............................................................

Name of the Dealing person with E-Code: Parminder Kaur (E2184)

Signature and date : .........................................

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