SI.NO.	Name of Exam	Name of Board/University	Year of Passing	Division & Class	Name of School/College	% of Marks
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SI.NO.	Pre- B.Ed.,Entrance Exam	Marks Obtained	Year of Passing	(Pre- B.Ed.,Entrance Exam Marksheet)
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I certify that the above statements are true I Undertake :(By student)

1. I, hereby, declare that, the entries made by me in the Application Form are complete and true to the best of my knowledge and based on records.
2. I, hereby, promise to abide by the rules and regulations of admission, discipline, attendance, fee deposits and fee withdrawal of the Institute and also to follow the Code of Conduct prescribed for the students of the Institute (www.stthomascollegebhilai.in), as in force from time to time and subsequent changes / modifications / amendement made thereto. I acknowledge that, the Institute has the authority for taking punitive actions against me for violation and / or non-compliance of the same.
3. I, further declare that, my admission may be cancelled, at any stage, if I am found ineligible and / or the information provided by me are found to be incorrect.
4. Ragging is a punishable offense and I have specifically gone through clause 7 and clause 9.1 of the regulations as well and I am fully aware of the same. Encouraging ragging, actively / passively, or being part of a conspiracy to promote ragging may result in punitive and administrative action against me.

Date

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Signature of Student

:

	I Undertake (by Parent)	:

1. I (Parent/ Guardian) hereby fully endorse the above undertaking / declaration given by my child / ward. And I will endeavour to induce my child / ward to do his / her best to observe the above stated undertaking in words & spirit.

Date

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Signature of Parent/Guardian

:

Note :

1. Bring all the original marksheets along with one copy print out of application form at the time of verification of documents as per notification.
2. Copies of all marksheets / caste cerrtificate (if any), aadhar card / TC & CC / Migration Certificate, Gap Certificate (if any)
3. Admission of a candidate will be cancelled if any of the statements is found incorrect

					Signature of the dealing personal