Admission Cancellation Undertaking

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APPLICATION FOR

ADMISSION CANCELLATION AND REFUND OF DUES


(To be filled by the candidate on Judicial Bond of Rs.30/-and duly attested by the Notary Public OR Oath
Commissioner).

Student’s Name: Father’s Name:


Name of Institution: Program (& Discipline):
Session: Year/Semester:
Amount Deposited: Receipt No. & Date:
Reason for Admission Cancellation:

Signature of Student: CNIC No.

Dated:
ENCLOSURE
• Fee Receipts(s) in original.
• Any other relevant documents.

FOR OFFICE USE ONLY


Date of Date of Date of Receipt No. of days between commencement of classes The Ratio of
Offer of Commencement of Application for OR offer of admission (in case admission is refund at which
Admission of Classes Admission offered after the commencement of classes) the amount is
Cancellation and receipt of application for admission required to be
cancellation. refunded (100%,
9/10/11 months
tuition fee
refund, 0%)

Certificate: Certified, that, as per record of this office, the above information is correct and verified.
The same is submitted for admission cancellation and refund of dues.

_____________________
Director/Principal
(Signature & Official Seal)

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