COUNSELLING/VERIFICATION FORM FOR ADMISSION

VISVA-BHARATI

1. APPLICATION ID………………………………………………………………………………………….
2. NAME OF THE STUDENT……………………………………………………………………...................
3. FATHER’S NAME………………………………………………………………………………………... PHOTO
4. D.O. B………..…… 5. GENDER: (MALE/FEMALE)
6. CATEGORY: (UR/SC/ST/OBC (NCL)/EWS/PWD/STAFF WARD/KM/CW)
7. BLOOD GROUP……
8. RELIGION……………………9. MINORITY: (YES/NO) 10. PWD: YES/NO11. EWS: YES / NO
12. STATE……………………………………
13. ALLOTTED CATEGORY: (UR/SC/ST/OBC (NCL)/EWS/PWD/STAFF WARD/KM/CW)
13. COURSE NAME: ………………………………………………………………………………………
FOR OFFICE USE:

14. PROVISIONAL ADMISSION DATE………………………….15. AMOUNT…………………………………

16. APPROVAL OF FIVE MEMBER COMMITTEE 17. SIGNATURE OF H.O.D. FOR VERIFICATION AND
CONFIRMATION

18. SIGNATURE OF THE PRINCIPAL FOR VERIFICATION AND

CONFIRMATION

20. MEDICAL INSURANCE & NCC/NSS/SPORTS

21. ALLOTTED ID

22. FINAL VERIFICATION SIGNATURE OF DEPARTMENTAL VERIFICATION COMMITTEE

CONFIRMATION *
ADMISSION CONFIRMED/NOT CONFIRMED

*only those cases where discrepancies are found to be reported to Admission Coordination Cell.
 VISVA-BHARATI SANTINIKETAN

Declaration

Student who have been enrolling at the School/ Pre-Degree/ Graduate/ Post Graduate/Ph.D./Other Courses of
different course under Visva-Bharati for the Academic Session __________ is hereby informed that he/she have
to attend classes regularly. At least 75% attendance is required to appear in all Semester Examinations.
Students, who have attendance between less than 75% and 60% have to pay Rs. 500.00 (Five Hundred) as fine
to enable them to appear in the Examinations. Students failing to have less than 60% attendance will not be
allowed under any circumstances to appear in the Semester Examinations. In such cases, those students have to
repeat the course in any Semester once again.

BA / B.Sc / M.A / M.Sc./B.Ed /M.Ed /B.P.Ed /M.P.Ed /Ph.D / Pre-Degree classes will commence from
__________. Students must attend at least 10 (Ten) full days of classes within _________ from the date of
commencement of classes, failing which their admission shall stand cancelled without any further notification.

We have carefully gone through the above and promise to abide by these rules.

[Signature of the Student] Name:

Date:
Course:

[Signature of Father / Mother / Guardian of the student] Name:

Date:
 AFFIDAVIT BY THE STUDENT

1. I, __________________________________________________________________________________ s/o
d/o Mr. / Mrs. / Ms. __________________________________________________________________
having been admitted to _________________________________________________________________
have received a copy of the UGC Regulations of Curbing the Menace of Ragging in Higher Educational
Institutes, 2009, (hereinafter called the “Regulations”) carefully read and fully understood the provisions
contained in the said Regulations.
2. I have in particular perused clause 3 of ht Regulations and am aware as to what constitutes ragging.
3. I have also in particular perused clause 7 and clause 9.1 of the Regulations 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 aver and undertake that
a. I will not indulge in any behavior of act that may be constituted as ragging under clause 3 of the Regulations.
b. I will not participate in or abet or propagate through any act of commission or omission 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 of punishment according to clause 9.1 of the
Regulations, without prejudice to any other criminal action that may be taken against my under any penal law
for the time being in force.
6.I Hereby declare that I have not been expelled of debarred from admission in any institution in the country on
account of being found guilty of, abetting or being part of a conspiracy to promote, ragging: and further affirm
that, in case the declaration is found to be untrue, I am aware that my admission is liable to be cancelled.
Declared this __________ day of __________________ month of ______________ year.

Name of the Student: Signature of deponent

(Student)

VERIFICATION
Verified that the contents of this affidavit are true to that best of my knowledge and no part of the affidavit is
false and nothing has been concealed or misstated therein.
Verified at _____________ on this the ___________ of ______________, __________________
(Place) (day) (month) (year)

Signature of deponent (Student)

Solemnly affirmed and signed my presence on this the __________ of ___________, __________. after reading
the contents of this affidavit. (day) (month) (year) AFFIDAVIT BY
PARENT / GUARDIAN
I, Mr. / Mrs/Ms. ________________________________________________________________ (full name of
parent/guardian) father/mother/guardian of, _____________________________
________________________________________________ (full name of student with admission / registration/
enrolment number), having been admitted to ___________________
_________________________________ (name of the institution) , have received a copy of the UGC
Regulations on Curbing the Menace of Ragging in Higher Educational Institutions, 2009, (hereinafter called the
“ Regulations”), carefully read and fully understood the provisions contained in the said Regulations.
2. I have in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging.
3. I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of the penal
and administrative action that is liable to be taken against my ward in case he/she is found guilty of or
abetting ragging, actively or passively, or being part of a conspiracy to promote ragging.
4. I hereby solemnly aver and undertake that.
a. My ward will not indulge in any behaviour or act that may be constituted as ragging under clause 3 of
the Regulations.
b.My ward 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, my ward is liable of punishment according to clause 9.1 of the
Regulations, without prejudice to any other criminal action that may be taken against my ward under any
penal law or nay law for the time being in force.
6. I hereby declare that my ward has not been expelled or debarred from admission in amy institution in the
country on account of being found guilty of, abetting or being part of a conspiracy to promote, ragging; and
further affirm that, in case the declaration is found to be untrue, the admission of my ward is liable to be
cancelled.

Declared this __________ day of __________________ month of ______________ year.

Name of the Guardian:

Address: Signature of deponent (Guardian)
Telephone / Mobile No:
VERIFICATION
Verified that the contents of this affidavit are true to that best of my knowledge and no part of the affidavit is
false and nothing has been concealed or misstated therein.
Verified at _____________ on this the ___________ of ______________, __________________
(Place) (day) (month) (year)

Signature of deponent
(Guardian)
Solemnly affirmed and signed my presence on this the __________ of ___________, __________. after reading
the contents of this affidavit. (day) (month) (year)

RULES OF CONDUCT FOR STUDENTS

1. All students must attend the Vaitalik preceding the morning classes. Student’s resident at Girls’ Hostels with
annexes and Patha-Bhavana dormitories are also to attend evening prayers.

2. All students are to attend the congregational service at the Mandir of Wednesday morning.

3. All students are to participate in the various co-curricular activities of the institution and actively share in the
corporate community life of the Ashrama. All students must attend the different functions and festivals of the
University.

4. Resident students, expect foreign students who are permitted to take meals in the University Kitchen, must
take their meals- principal and light meals- in the Refectory at appointed hours, perform the duties allotted to
them by the Refectory Committee and observe general rules of courtesy and discipline in the Refectory.
5. Resident students must take care to keep their respective rooms clean and tidy.
6. They must not cause any damage to any University property and must not tamper with electric installations in
their hostels. Any willful damage of University property will be changed against the student concerned. Use
of unauthorized fans, heaters, electric stoves etc. is forbidden.

7. All students must return to their respective rooms after the last retiring bell and observe silence. They are not
to go into the rooms of other students after the last retiring bell. None will be allowed to go out of the premise
after the last retiring bell without the permission of the Adhyaksha / Proctor / Warden / Hostel Paridarsika /
Foreign Students’ Advisor.

8. Students returning to the hostels beyond the last retiring bell must sign the gate book with the Supdt. / Warden
/ Hostel Paridarsika and must answer satisfactorily all queries by the Adhyaksha / Proctor / Warden / Hostel
Hostel Paridarsika / Foreign Students’ Advisor.

9. No outsider or day-scholar or resident of a different hostel will be allowed to visit the boarders of a dormitory
outside specified hours to be notified by the Adhyaksha / Proctor / Warden / Hostel Paridarsika / Foreign
Students’ Advisor. In particular, no male students/ visitor is allowed to remain within the premises of girls’
hostels after the evening Upasana.

10. Students are to take permission of the Warden /Hostel Paridarsika / Adhyaksha while going out of the
campus of the University and must obtain leave before they go our station.

11. Students desirous of leaving station will be required to apply for leave in the prescribed form. All leave
applications are to be submitted through the Warden / Hostel Paridarsika to the Adhyaksha / Foreign
Students’ Advisor. No student will leave station before the leave prayed for is granted in writing.

12. Students are required to maintain required minimum percentage of attendance in classes to be eligible
to sit for any examination under the semester or annual system.

13. Following the order of the Honourable Supreme Court of India on curbing Ragging in the University, it
has been decided that if any incident of ragging comes to the notice of the authority, the concerned student
shall be given liberty to explain and if his explanation is not found satisfactory, the authority would expel him
/ her from the University.

ADDITIONAL RULES FOR FEMALE STUDENTS

1. Boarders of Girls’ Hostel with annexes must return straightway to their hostels after the evening Upasana and
also after taking meals in the Refectory.

2. Except in the Sangit-Bhavana Block, music and dance are strictly forbidden during the study period.

3. a. On Wednesday and notified University holidays visiting hours at the girls hostels will be observed from 08-
30 a.m to 10.-00 a.m and from 04-00 p.m to 07-00 p.m.
b. On other days visiting hours will be specified by the respective controlling officer of the Hostels.

4. No outsider or day-scholar or resident male student will be allowed to visit girl boarders in the hostels outside
the hours as indicated above.

5. The girl students will take permission of the Paridarsika while going out of the campus of the University and
must obtain leave in writing before they go out of station.
6. Only such person as have been approved of by the natural guardians of students at the time of admission will
be allowed to visit the boarders of the Girls Hostels at appointed hours as mentioned in rule No. 4 above
except that in case of emergency, special permission may be granted by the Paridarsika to any person to see
the boarder concerned at any time. Visitors are not allowed to visit Girls’ Hostels ordinarily after 8 p.m.

7. Boarders wishing to call at the house of their local guardians may be permitted to go and stay with their local
guardians on Wednesday and on University holidays on production of a letter of request from the local
guardian to that effect.

8. Girls students shall not be allowed to meet visitors at the Guest House without previous permission of the
Paridarsika. Girls students shall not be allowed to go anywhere outside the Ashrama area without proper
escorts’ authorized by the Paridarsika or the Adhyaksha of the Bhavana concerned.

Permission of the Paridarsika will be required for keeping guests.

I have carefully gone through the above rules and I promise to abide by them.

Signature of the Student Date:

Countersigned

Father / Mother / Guardian of the Student Date: