Proxy Registration Form for Students

Name of the Applicant :   Mr. Vishal Rai

Date of Birth : 09/08/1999 Paste Your
Enrollment Number : 384962 Self Attested
Course Studying : M.COM Photograph
Institute/Faculty/Unit : Faculty of Commerce
Department : Commerce
Whether Hostelar : yes Hostel Name : Dr. I.N. Gurtu Hostel
Date of Course Completion : 30/06/2021
Whether Research Scholar : no
Old Login Id :
Mobile Number : 9919463294
Nationality : Indian
Email ID : vhrai905@gmail.com
Your Proxy Username is "508.384962" (KINDLY NOTE IT DOWN)

Undertaking :

1. I shall be responsible for all the transaction from my ID.

2. I will be responsible for all the content browsing using the ID allotted to me.
3. I understand that IT infrastructure of the B.H.U is for academic use. Also, I shall not misuse it and I will take due care of any
misuses that might harm others in any means and/or may be otherwise considered objectionable or illegal as per Indian
Cyber Laws. In any such cases of misuses I do take full responsibility of it.
4. I will not intrude on privacy of anyone.
5. I understand that the IT Resources provided to me are subject to monitoring to the legal or law enforcement. I authorize
B.H.U Administration & Computer Centre to perform network vulnerability and scans over my ID, as and when needed for
protecting the overall Integrity and efficiency of the B.H.U. Network.
6. I understand that any use of IT infrastructure that constitutes a violation of the University Regulations could result in
administrative or disciplinary procedures.
7. I WILL ABIDE BY ALL THE ABOVE UNDERTAKINGS WITHOUT FAIL.

Date: 04/08/2019
Place:Varanasi (Signature of the Applicant)

Declaration by The Head/Dean of the Department

This is to Certify that is a regular student of our Department/Faculty and he/she needs an Internet proxy ID for his/her studies.

Date: Signature of the Head/Dean

Place: Varanasi (With Office Seal)       

Declaration by The Warden/Admin Warden of the Hostel

(Applicable for only those students who resides at B.H.U. Hostels)

This is to Certify that is a resident of the . He/She needs an Internet proxy ID for his/her studies.

Date:
Signature of the Warden/Admin Warden
Place: Varanasi
(With office Seal)       
 RECEIPT
has been assigned the following Proxy ID :

USER ID : 508.384962
PROXY SERVER : ___________________________
The above Proxy ID is allotted for the period upto:

Date:
Signature               
Place: Varanasi

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