REGISTRATION FORM (Session 2020-2021)

Program Applying For

[_serial_number]



PERSONAL INFORMATION









MaleFemale

YesNo

RuralUrban
PERMANENT ADDRESS

(For all communication the college)













CATEGORY INFORMATION

(Only for students willing to avail any scholarship)







BANK DETAILS






CATEGORY CERTIFICATE DETAILS:




OTHER INFORMATION


YesNo

YesNo

YesNo

YesNo

QUALIFICATION DETAILS

Summary of Academic Information

(Fill whichever is applicable)

Exam.PassedYear of PassingName of Board/Uni.Name of School/CollegeBoard/Unv. Roll NumberStream/Main Subjects StudiedTotal Marks ObtainedMax. Marks% of Marks/SGPARemarks/Result Status
10th
+2
Diploma
Graduation
Post Graduation
Any Other Qualification



YesNo


DECLARATIONS

Declaration by the Applicant/Student


HEREBY DECLARE

  1. that I have read all the rules governing my provisional admission in KMS College of IT & Management, Dasuya.
  2. that I have filled the application form after throughly understanding there rules and the information filled by me in the application form is correct and true to the best of my knowledge and belief.
  3. that I have never been convicted by any court and not been debarred or disqualified by any Board/Univeristy from appearing in any examination.
  4. that I shall not indulge in any form of ragging or any in disciplinary activities and shall strictly abide by the code of conduct.
  5. I am fully aware of prevailing rules regarding fulfillment the criteria of 75% attendance for my eligibility to apply and appear in the Examination.
  6. that Fees once deposited under any head will not be refunded.
  7. that all matters subject to Jurisdiction of Dasuya Court.

I AGREE

  1. that the admission granted to me is purely on a provisional basis subject to university approval of courses. #All final admissions / confirmation / decisions will depend upon set procedures through University Notifications.
  2. to the prevailing rules and regulations in force or that may hereafter amended time to time.
  3. that so long as I am a student of the KMS College of IT & Management, Dasuya. I will not involve myself directly or indirectly in disciplinary activities like loss to College & Hostel property / theft case / ragging / fighting / quarreling / use of abusive language / misbehave with follow students, juniors / seniors within campus or with outsiders at public places and also with Staff members failing which disciplinary action shall be initiated against me as deemed necessary or may be handed over to police for legal proceedings according to nature of offence.
  4. to execute the Agreement as prescribed by the Management at the time of admission.
  5. that the Principal/Director of KMS College of IT & Management, Dasuya, will have full liberty to expel me for any infringement of the above undertaking.
  6. that it is my sole responsibility to submit / produce the eligibility documents and in case of non-availbility of eligibility document, my admission will automatically be stands cancelled on the last date prescribed for admission and that I shall have no claim of any nature at any stage on the College in the event of cancellation of my admission for non-fulfillment of any conditions stipulated and agreed to.
  7. that College has the right to publish applicants photo’s in media for promotional activities.
  8. to pay all the relevant fees such as Enrollment / Eligibility Check / Examination / Re-evaluation / Activity etc. as described by University norms within given time,
  9. that my candidature / admission may be cancelled and appropriate action be taken against me at any stage, if my certificate/document is found false or if any information furnished by me is found to be incorrect or misleading.
Declaration by the Parents/Legal Guardian


  1. Hereby Declare that the information given by my ward is true and correct to the best of my knowledge. I have gone through the rules governing the admission and conduct of my ward in the college and I agree to abide by the decision of the Management. I undertake to ensure that my ward shall not involve himself/herself directly or indirectly in disciplinary activities like loss to College & Hostel property / theft case / ragging / fighting / quarreling / use of a abusive language / misbehave with fellow students, juniors / seniors or with outsiders within campus or at public places and also with Staff members through out his / her studies in the College till the completion of course.

I hereby agree that I will deposit the following -

  1. Eight Passport size color photographs
  2. 10th Certificate/Markssheet (for proof of DOB) - Original & attested Photocopy
  3. 10+2/Graduation/Diploma Marksheet and Certificate - Original & attested Photocopy (whenever I receive)
  4. Migration Certificate - Original & attested Photocopy (whenever I receive)
  5. Attested Photocopy of Aadhaar Card (Student’s / Father’s / Mother’s)
  6. Caste / Category / Low Income Certificate - Original & attested Photocopy Copy (only for students applying for a scholarship)
  7. Photocopy of Bank Passbook mentioning Bank Account Number (only for students applying for a scholarship)