form - inspiria knowledge campus · 7. my son/ daughter/ ward will concentrate on his/her studies...

www.inspiria.edu.in Affiliated to MAKAUT

APPLICATION FORM

Application No..................................................

Mother’s Name

Father’s Name

Father’s Occupation

Permanent Address

City State PIN

E-mail Contact

Name of The Applicant

Date of Birth Gender M F

E-mail

Nationality Mother Tongue

D D M M Y Y Y Y/ /

Affix a recentcolour

passport sizephotograph

Affiliated to Maulana Abul Kalam Azad University of Technology (MAKAUT)(Formerly known as West Bengal University of Technology)

ReadLanguages

English

Hindi

Bengali

Nepali

Others(Mention)

Write Speak

LANGUAGES KNOWN

School/College

Board/University

Major Subjects

Year ofPassing

Division/Percentage

EDUCATIONAL BACKGROUND

Course interested in: Bachelor of Business Administration - BBA(H)

Bachelor of Computer Application BCA(H)

Bachelor in Media Sciences B.Sc.(H)

BBM(H) in Hospitality Management

Siliguri

My Preferred Entrance Test Location: 1)______________________

2)______________________

3)______________________

Games_______________________________________________________________________________

Social Activities________________________________________________________________________

Hobbies______________________________________________________________________________

GuwahatiGangtok Darjeeling

Extracurricular Activities

Entrance Test Location

Declaration

I hereby declare that the information provided by me is true and accurate to the best of my knowledge and I shallbe liable for any misrepresentation if detected during verification by Inspiria Knowledge Campus.

.....................................................Date

..................................................................Signature of the Applicant

Kolkata

Report (For Office use only)

Written Test Group Discussion

Verified Original Documents

Registration Details

Interview

Date.............................................

Result..........................................

Conducted by...............................

Remarks.....................................................................................................................................................

...................................................................................................................................................................

Batch Code__________________Payment Type___________________ Net Fees___________________

Date of Birth Certificate Yes No 10+2 Marksheet Yes No Stream_____________

Transfer/Migration Yes No 10+2 Certificate Yes No

Date.............................................

Result..........................................

Conducted by...............................

Date.............................................

Result..........................................

Conducted by...............................

.........................................................................Signature of the Academic Counsellor

I declare that

a) I have not taken admission in any institute after passing the H.S. / 10+2.

b) I joined ______________________________________________________in the session _____________

under_____________________________________university and the transfer certificate will be presented

after I get admission to Inspiria Knowledge Campus.

c) Application fee paid in Cash DD

DD No.___________________Dated____________Bank____________________________

D D M M Y Y Y Y/ /

HOSTEL APPLICATION FORM

MEDICAL CERTIFICATE

PERSONAL DETAILS

FOR OFFICE USE ONLY

OTHER INFORMATION

OTHER INFORMATION

Course......................................Registration No. .....................................Batch Code ................................

Father’s Occupation

Mother’s Occupation

Guardian’s Occupation

Guardian’s Monthly Salary/Income

Guardian’s Contact No

Date of Birth

Date of Birth............................Gender.....................Height(in cm).............................

Weight............................Blood Group..................Blood Pressure.............................

Gender M F Marital Status

Permanent Address

Phone (O) (R) (M)

Fax E-mail

Name

LOCAL GUARDIAN

Address

Phone (O) (R) (M)

Fax E-mail

Name

Has the applicant suffered from appendicitis/tuberculosis/epilepsy/cardiac problem/jaundice?...................

Is he/she allergic to any medicine?.............................................................................................................

Has he/she undergone any surgery?..........................................................................................................

Has he/she been immunised against any of the following?.........................................................................

Hepatitis (Date & Dose)..................................... Tetanus (Date & Dose)....................................................

Poliomyelitis (Date & Dose)........................................................................................................................

Doctor’s General Impression.............................................. Special diet?...................................................

I hereby certify that the applicant does not carry any infectious disease and has an excellent state of health.

His/her physical and mental condition can fulfil the requirements of a professional career.

Date.......................Place......................

...................................................................Name of the Physician &

Signature with seal

.............................................Registration No.

Father’s/Guardian’s Name

PERSONAL DETAILS

Permanent Address ..................................................................................................

Phone (O)....................................(R)....................................(M)...............................

Name........................................................................................................................

Father’s/Guardian’s Name ........................................................................................






RULES AND REGULATIONS

Academic Qualifications

Special Requirements

Admission Process

Fee Structure

Cost of Prospectus

Age

1. Applicants must have appeared or passed the H.S./ISC/CBSE or any (10+2) exam from a recognized

intermediate examination.

2. Applicants must have English as a compulsory subject in the H.S. (10+2) lavel.

1. Applicants must be of minimum seventeen years on or before joining the course.

1. Applicants for BCA(H) (Bachelor of Computer Applications) must have one of the following subjects

at the (10+2) lavel:-

Mathematics/ Computer Application/ Statistics/ Business Mathematics.

1. Students appearing for classXII board exam are also eligible to apply. However admission in such cases

shall be provisional till he/she clears the (10+2) board exam.

2. It is to be noted that all admission to Inspiria Knowledge Campus shall be confirmed only after fullfilment of the

eligibility criteria specified Maulana Abul Kalam Azad University of Technology (formerly known as WBUT) .

3. Eligibility details are available at www.wbut.ac.in (MAKAUT website).

1. All payments to be made in Cash or DD/Pay Order in favour of Inspiria Knowledge Campus Payable at

Siliguri.

2. Admission fees paid during admission/registration is non-refundable.

1. The cost of prospectus is Rs 500/- by hand and Rs. 550/- by Post.

2. To receive the prospectus by post, applicants are requested to send a Demand Draft(DD) by post to Inspiria

Knowledge Campus, Himachal Vihar, Phase-II, Matigara, Siliguri 734010. The draft should be drawn in favour

of Inspiria Knowledge Campus and payable at Siliguri. Applicants must clearly mention their postal address

on a blank piece of paper which should be enclosed with the draft

Hostel Fees (Subject to Availability)Hostel Fees are for the period “July 2016 to June 2017”. Hostel charges include accommodation

charges, electricity, breakfast, lunch, tea and dinner. Any incremental changes in the successive

year will be notified in advance.

Siliguri Rs. 7500.00

Per Month Hostel Fixed ChargesCampus


FEE STRUCTURE

Students will be provided with 2 shirts, 1 trouser, 1 business suit, 1 tie, 1 Bag. Students will also be able to access all facilities available at

the campus. All University charges like Registration Fee, Development Fee, and Exam Fee etc. have to be paid by the student, separately

to the University.

Inspiria Knowledge Campus

Fee Structure

Sl. No.

Sl. No. Fees Details

Course Name Duration Semester

Total 2,16,000

TotalFees payable at the time of Admission

Total Course Fees for 3 Years (Semester fees + 1 time payment)

40,00076,000

2,56,000

Semester 1Semester 2Semester 3Semester 4Semester 5Semester 6

36,00036,00036,00036,00036,00036,000

Amount (Rs.)

Amount (Rs.)

BBA(H)/BCA(H)/B.Sc(H) Media ScienceTuition fees of the Academic Session 2016-2019

1

1 Development FeesAdmission Fees

Interest Free Security Deposit (Refundable)

Library Fees (Refundable)

234

10,00010,000

15,0005,000

BBA(H)/BCA(H)/B.Sc(H) in

Media Science

3 Years

ONE TIME PAYMENTS (To be paid at the time of admission along with 1st semester Fees)

Sl. No.

Sl. No. Fees Details

Course Name Duration Semester

Total 3,00,000

TotalFees payable at the time of Admission

Total Course Fees for 3 Years (Semester fees + 1 time payment)

43,00093,000

3,43,000

Semester 1Semester 2Semester 3Semester 4Semester 5Semester 6

50,00050,00050,00050,00050,00050,000

Amount (Rs.)

Amount (Rs.)

BBM(H) in Hospitality ManagementTuition fees of the Academic Session 2016-2019

1

1 Development FeesAdmission Fees

Interest Free Security Deposit (Refundable)

Library Fees (Refundable)Lab Uniform

2345

10,00010,000

15,0005,0003,000

BBM(H) in Hospitality

Management3 Years

ONE TIME PAYMENTS (To be paid at the time of admission along with 1st semester Fees)

SELF-DECLARATION BY PARENTS/GUARDIANInspiria Knowledge Campus

Undertaking by Parents/ Guardian “To be aware and abide by the essential internal rules and regulations, from the first day

of starting session of classes, the following Undertaking Form is introduced which should be signed by the parent/ guardian.

The same should be submitted to the administrative department at the time of provisional admission only.”

I, Mr. / Mrs. ___________________________________________________________ DOB ________________ parent/

guardian of Mr./ Ms. _____________________________________ Enrollment No. ____________________ have provi-

sionally enrolled my son/ daughter/ ward for academic year 2016-17 in Inspiria Knowledge Campus, Siliguri do hereby

undertake and abide by the following terms, and hereby submitting the ACKNOWLEDGEMENT duly signed by me on _____

day of __________ 2016.

1. I hereby acknowledge that confirmation of admission is subject to be verification of documents from the

university, if at any stage the documents submitted are found invalid/fake, registration shall stand cancel.

2. My son/ daughter/ ward shall be registered under provisional admission until the university confirms and

accepts their registration.

3. My son/ daughter/ ward shall attend all classes from the day of commencement of academic year 2016-17 as

per the timetable. In case, they do not turn up even after one week of class commencement, he/she shall be

ineligible to continue for the current academic year.

4. My son/ daughter/ ward shall be regular and punctual in all classes (theory/practical/drawing) and secure

attendance of not less than 85% in each subject as stipulated by MAKAUT. I am fully aware that attendance less

than 85% in any of the subjects will debar them from appearing in examinations and he/she shall have to repeat

the semester/ year as applicable.

5. My son/ daughter/ ward will compulsorily follow the dress code and uniform prescribed by the college.

6. My son/ daughter/ ward will conduct in a disciplined and decent manner both inside the classroom and in the

campus, failing which suitable action may be taken against them as per the rules, regulations and standing

orders of the college.

7. My son/ daughter/ ward will concentrate on his/her studies without wasting time in the campus/hostel/residence

and attend all the tests to secure more than the minimum prescribed class / sessional marks in each subject.

They shall submit the assignments given in time to improve their performance.

8. I have received a copy of the UGC/ WBUT(Now MAKAUT) Regulations on Curbing the Menace of Ragging in

Higher Educational Institutions, 2009, (hereinafter called the "Regulations") and have carefully read and fully

understood the; provisions contained in the said Regulations and have explained the same to my son/ daughter/ ward.

9. We have, in particular, perused clause 3 of the Regulations and are aware as to what constitutes ragging.

10. We have also, in particular, perused clause 7 and clause 9.1 of the Regulations and are fully aware of the penal

and administrative action that is liable to be taken against my son/ daughter/ ward in case he/she is found guilty of

abetting ragging, actively or passively, or being part of a conspiracy to encourage ragging.

11. I hereby solemnly aver and undertake that my son/ daughter/ ward will not indulge in any behavior or act that

may be constituted as ragging under clause 3 of the regulations.

12. My son/ daughter/ 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.

www.inspiria.edu.in

SELF-DECLARATION BY PARENTS/GUARDIANInspiria Knowledge Campus

SELF-DECLARATION

13. I hereby affirm that, if found guilty of ragging, My son/ daughter/ ward be liable for punishment according to

clause 9.1 of the Regulations, without prejudice to any other criminal action that may be taken against them under

any penal law or any law for the time being in force.

14. I hereby declare that my son/ daughter/ ward has not been expelled or 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 son/ daughter/ ward’s

admission is liable to be cancelled.

15. I will pay tuition fees, examination fees and any other dues within the stipulated time as required by the college

authorities failing which my son/ daughter/ ward will not be permitted to attend the classes. The administration

shall have the right to expel students for non-payment of fees within reasonable period of time.

16. My son/ daughter/ ward will not cause or involve in any act of violence or disturbance both within and outside the

college campus.

17. If my son/ daughter/ ward absents himself/herself for three days at a stretch, he/she will be required to state valid

grounds for such absence and the supporting documents will have to be submitted to the administrative department

of the college.

Signature of Parent/ Guardian

Name:______________________________________

Address:____________________________________

___________________________________________

Mobile No. : _________________________________

Verified that the contents of this self-declaration have been verified by I, Mr./Ms.____________________________________

____________________________________________________________________ DOB_________________Resident of,

_______________________________________________________________________________________________

Parent/ Guardian of Mr./ Ms. _______________________________________________________ are true to the best of my

knowledge and no part of the declaration is false and nothing has been concealed or misstated therein.


Date:

Place:

www.inspiria.edu.in

RAGGING: PROHIBITION, PREVENTION AND PUNISHMENTInspiria Knowledge Campus

The University Grants Commission vide its letter no F.1-16/2007 (CPP-II) dated June 17, 2009 has reiterated the ban on

ragging of students in Institutions of higher learning. The students are therefore directed to strictly desist from any kind of

ragging.

Forms of Ragging:

Display of noisy, disorderly conduct, teasing, excitement by rough or rude treatment or handling, including rowdy, undisci-

plined activities which cause or likely to cause annoyance, undue hardship, physical or psychological harm or raise appre-

hensive fear in a fresher, or asking the students to do any act or perform something which such a student will not do in the

ordinary course and which causes him/her shame or embarrassment or danger to his/her life, etc.

Punishment for Participation in/or Abetment of Ragging :

1. Cancellation of admission.

2. Suspension from attending classes.

3. Withholding/withdrawing scholarship/fellowship and other benefits.

4. Debarring from appearing in any test/examination or other evaluation process.

5. Withholding results.

6. Debarring from representing the institution in any national or international meet, tournament, youth festival, etc.

7. Suspension/expulsion from the hostel.

8. Rustication from the institution for periods varying from 1 to 4 semesters or equivalent period.

9. Expulsion from the institution and consequent debarring from admission to any other institution.

10. Fine up to a sum of Rs. 25,000/-

Affidavit by students and parents :

Each student and his/her parents/ guardian shall have to furnish an affidavit alongwith the application form to the effect that

they will not participate in or abet the act of ragging and that, if found guilty, shall be liable for punishment under the penal

law of India.

www.inspiria.edu.in

SELF DECLARATION BY PARENTS/GUARDIANSInspiria Knowledge Campus

SELF DECLARATION BY PARENTS/GUARDIAN

Verified that the contents of this self declaration are true to the best of my knowledge and no part of the self declaration is

false and nothing has been concealed or misstated therein.

Signature of Father/Mother/Guardian

Verified at (Place)____________

on this the (day)_________ of (month),_________ (year)__________

1) Mr./Mrs./Ms.__________________________________________________________________________________(full

name) of parents/ guardians) father/mother/guardian of full name of student with admission/registration/ enrollment

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 adminis-

trative 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 for 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 any law for the time

being in force.

6)I hereby declare that my ward has not been expelled or 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, the admission of my ward is liable to be cancelled.

Declared this on _______ day of _________ month of __________ year.

Signature of Father/Mother/Guardian

Name : ____________________________________________

Address: ___________________________________________

__________________________________________________

Telephone/Mobile No. ________________________________

www.inspiria.edu.in

SELF DECLARATION

SELF DECLARATION BY THE STUDENT

I _________________________________________________________________ (with admission/registration/enrollment

number) s/o d/o Sh.____________________________________________________________________________having

been admitted to______________________________________________, have received a copy of the UGC Regulations

on Curbing the Menance of Ragging in HIgher Education 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 admin-

istrative 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 behaviour or 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 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) I hereby declare that I have not been expelled or 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 declara-

tion is found to be untrue, I am aware that my admission is liable to be cancelled.

Declared this on _________________ day of _________ month of __________ year.

Signature of Student

Name : ____________________________________

Address:___________________________________

___________________________________________

Telephone/Mobile No. _______________________

Verified that the contents of this self declaration are true to the best of my knowledge and no part of the self declaration is

false and nothing has been concealed or misstated therein.

Signature of the Student

Verified at (Place)____________

on this (day)_________ of (month),_________ (year)__________

www.inspiria.edu.in

CLAUSE -3 WHAT CONSTITUTES RAGGING :

Ragging constitutes one or any of the follows acts:

Any conduct by any student or students whether by words spoken or written or by an act which has the effect of teasing,

treating or handling with rudeness a fresher or any other student.

Indulging in rowdy or indisciplined activities by any student or students which causes or is likely to cause annoyance,

hardship, physical or psychological harm or to raise fear or apprehension thereof in any fresher or any other student;

Asking any student to do any act which such student will not in the ordinary course do and which has the effect of causing

or generating a sense of shame, or torment or embarrassment so as to adversely affect the physique or psyche of such

fresher or any other student.

Any act by a senior student that prevents, disrupts or disturbs the regular academic activity of any other student or a fresher;

Exploiting the services of a fresher or any other student for completing the academic tasks assigned to an individual or a

group of students.

Any act of financial extortion or forceful expenditure burden put on a fresher or any other student by students;

Any act of physical abuse including all variants of it: sexual abuse, homosexual assaults, stripping, forcing obscene and

lewd acts, gestures, causing bodily harm or any other danger to health or person;

Any act or abuse by spoken words, emails, post, public insults which would also include deriving perverted pleasure, vicari-

ous or sadistic thrill from actively or passively participating in the discomfiture to fresher or any other student;

Any act that affects the mental health and self-confidence of a fresher or any other student.

with or without an intent to derive a sadistic pleasure or showing off power, authority or superiority by a student over any

fresher or any other student.

On receipt of the recommendation of the Anti Ragging Squad or on receipt of any information concerning any reported

incident of ragging, the Head of Institution shall immediately determine if a case under the penal laws is made and if so,

either on his own or through a member of the Anti-Ragging Committee authorized by him in this behalf, proceed to file a

First Information Report (FIR), within twenty four hours of receipt of such information or recommendation, with the police

and local authorities, under the appropriate penal provisions relating to one or more of the following, namely;

i) Abetment to ragging

ii) Criminal conspiracy to rag

iii) Unlawful assembly and rioting while ragging

iv) Public nuisance created during ragging

v) Violation of decency and morals through ragging

vi) Injury to body, causing hurt or grievous hurt

vii) Wrongful restraint

viii) Wrongful confinement

ix) Use of criminal force

x) Assault as well as sexual offences or unnatural offences

xi) Extortion

xii) Criminal trespass

xiii) Offences against property

CLAUSE -7 ACTION TO BE TAKEN BY THE HEAD OF THE INSTITUTION :

www.inspiria.edu.in

xiv) Criminal intimidation

xv) Attempts to commit any or all of the above mentioned offences against the victim(s)

xvi) Threat to commit any or all of the above mentioned offences against the victim(s)

xvii) Physical or psychological humilliation

xviii) All other offences following from the definition of "Ragging"

Provided that the Head of institution shall forthwith report the occurrence of the incident of ragging to the District Level

Anti-Ragging Committee and the Nodal officer of the affiliating University, if the institution is an affiliated institution.

Provided further that the institution shall also continue with its own enquiry initiated under clause 9 of these Regulations and

other measures without waiting for action on the part of the police/local authorities and such remedial action shall be initiat-

ed and completed immediately and in no case later than a period of seven days of the reported occurrence of the incident

of ragging.

9.1 The institution shall punish a student found guilty of ragging after following the procedure and in the manner

prescribed hereinunder:

a) The Anti-Ragging Committee of the institution shall take an appropriate decision, in regard to punishment or otherwise,

depending on the facts of each incident of ragging and nature and gravity of the incident of ragging established in the recom-

mendations of the Anti-Ragging Squad.

b) The Anti-Ragging Committee may, depending on the nature and gravity of the guilt established by the Anti Ragging

Squad, award, to those found guilty, one or more of the following punishments, namely;

i) Suspension from attending classes and academic privileges.

ii) Withholding/withdrawing scholarship/fellowship and other benefits.

iii) Debarring from appearing in any test/examination or other evaluation process.

iv) Withholding results.

v) Debarring from representing the institution in any regional, national or international meet, tournament, youth festival etc.

vi) Suspension/expulsion from the hostel.

vii) Cancellation of admission

viii) Rustication from the institution for period ranging from one to four semesters.

ix) Expulsion from the institution and consequent debarring from admission to any other institution for a specified period.

Provided that whether the persons committing or abetting the act of ragging are not identified, the institution shall resort to

collective punishment.

c) An appeal against the order of punishment by the Anti-Ragging Committee shall lie,

i) In case of an order of an institution, affiliated to or constituent part, of a University, to the Vice Chancellor of the University.

ii) In case of an order of University, to its Chancellor

iii) In case of an institution of national importance created by an Act of Parliament, to the Chairman or Chancellor of the

institution, as the case may be.

CLAUSE -9 ADMINISTRATIVE ACTION IN THE EVENT OF RAGGING :

www.inspiria.edu.in

Undertaking by student “To be aware and abide by the essential internal rules and regulations, from the first day of starting

of classes, the following Undertaking Form is introduced which should be signed by the student. The same should be

submitted to the administrative department at the time of provisional admission only.”

1. I hereby acknowledge that confirmation of admission is subject to verification of documents from the university.

If at any stage the documents submitted are found invalid/fake registration shall stand cancel.

2. I shall be registered under provisional admission until the university confirms and accepts their registration.

3. I shall attend all classes from the day of commencement of academic year 2016-17 as per the timetable. In

case, I do not turn up even after one week of class commencement, I shall be ineligible to continue for the current

academic year.

4. I shall be regular and punctual in all the classes (theory/practical/drawing) and secure attendance of not less than

85% in each subject as stipulated by MAKAUT. I am fully aware that attendance less than 85% in any of the

subjects will debar me from appearing in examinations and I shall have to repeat the semester/ year as applicable.

5. I will compulsorily follow the dress code and uniform prescribed by the college.

6. I will conduct in a disciplined and decent manner both inside the classroom and in the campus, failing which suitable

action may be taken against me as per the rules, regulations and standing orders of the college.

7. I will concentrate on my studies without wasting time in the campus/hostel/residence and attend all the tests to

secure more than the minimum prescribed class / sessional marks in each subject. I shall submit the

assignments given in time to improve my performance.

8. I have received a copy of the UGC/ WBUT(Now MAKAUT) Regulations on Curbing the Menace of Ragging in

Higher Education Institutions, 2009, (hereinafter called the "Regulations") carefully read and fully understood the;

provisions contained the said Regulations.

9. I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging.

10. 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 encourage ragging.

11. I hereby solemnly aver and undertake that I will not indulge in any behavior or act that may be constituted as

ragging under clause 3 of the regulations.

12. 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.

I, Mr. / Ms. _________________________________________________________, DOB_____________, Son/ Daughter

of Mr./ Ms. ___________________________________, Enroll No. _________________, have been provisionally enrolled

for academic year 2016 -17 in Inspiria Knowledge Campus, Siliguri do hereby undertake and abide by the following terms,

and hereby submitting the ACKNOWLEDGEMENT duly signed by me on ______day of _________ 2016.

SELF-DECLARATION BY STUDENTSInspiria Knowledge Campus

www.inspiria.edu.in

13. I hereby affirm that, if found guilty of ragging, I will be liable for punishment according to clause 9.1 of the

Regulations, without prejudice to any other criminal action that may be taken against them under any penal law

or any law for the time being in force.

14. I hereby declare that I have not been expelled or 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.

15. I will pay tuition fees, examination fees and any other dues within the stipulated time as required by the college

authorities failing which I will not be permitted to attend the classes. The administration shall have the right to

expel for non-payment of fees within reasonable period of time.

16. I will not cause or involve in any act of violence or disturbance both within and outside the college campus.

17. If I am absent for 3 days at a stretch, I will be required to state valid grounds for such absence and the supporting

documents will have to be submitted to the administrative department of the college.

Signature of Student

Name: ______________________________________

Address: ____________________________________

___________________________________________

Mobile No.: __________________________________


Date:

Place:

SELF-DECLARATION BY STUDENTSInspiria Knowledge Campus

SELF DECLARATION

The contents of this self-declaration have been verified by I, Mr. / Ms.__________________________________________

_______________________, DOB_______________, Resident of____________________________________________

_________________________________________________________________________________________________

.________________________ son/ daughter of Mr./ Ms. ___________________________________________________

are true to the best of my knowledge and no part of the declaration is false and nothing has been concealed or misstated

therein.

www.inspiria.edu.in