Form No.(For Office Use Only): ...................

SAI NATH UNIVERSITY

(Established by State Government & Recognized as per section 2 f of UGC Act, 1956)

Admission Application Form

Course...........................................................................Department..............................................................
1. Name : ...........................................
2. Fathers Name:
Affixed passport size
photograph. The applicant should be signed
over the photo at the
bottom.

3. Date of Birth: ..
4. Present Address (in block letters): ......
...............
5. Phone No.: .. Mobile: . Email: ............

6. Correspondence Address: ........................................

...... PIN ..........................................
7. Category: General/SC/ST/OBC Annual Income.................................Gender: Male/Female .
9. Qualifications :

Exam

Year of Passing

Board/University

Subjects

Passing %

Photocopy
attached?

10. Fee deposition Detail: Fee amount....................................Bank Name..........................................Account no.............................

Deposition Date:..................................Mode of payment................................challan/DD/Cheque number.....................................
DECLARATION
I..........Son/Daughter/wife of solemnly declare and affirm that I am duly qualified to take admission in the course
for which I have applied and all the certificates and testimonials attached with my application are true and valid. I have fully satisfied myself about
the legal status of the University i.e. it is an autonomous statutory body with regulations making power for its functioning. University is duly
authorized and competent to take my admission in the course for which I have applied. I also undertake not to ever raise any objection about
Universities legal status to take my admission and award degrees on qualifying prescribed examinations. I also undertake not to demand refund
of fee/charges paid by me. In case of any dispute/differences/claim or disciplinary action settlement by University arbitration clause shall be
applicable.

I shall always follow the rules and regulations of the University and in case of any breach thereto, I shall be liable to be penalized for
the same which may include expulsion from the University.

(Signature of Guardian)
Date :

(Signature of Candidate)
Place : Ranchi, Jharkhand