SELF DECLARATION FORM

1) That I am a Father /Mother of ____________________________ who is seeking

admission in your institute for the preparation of Govt Competition Exams/ IELTS/
Spoken English. His Date of birth is____________.

2) I am giving my full consent to my son/ daughter to join the class regularly.

3) I assure you that my son/ daughter will follow all the guidelines issued by Punjab
Govt and Center Govt of India in Covid-19 period.

4) He/ She will sanitize their hands and will wear Mask regularly and will maintain
the social distance during the class

5) I also confirm that my son/ daughter is physically fit and if at any stage he/ she
will have any kind of symptoms of fever, cold and cough. He/ She will not
continue his/ her classes.

6) I confirm that the information provided above is true and correct to the best of my
knowledge.

I also confirm that, if at any stage this information submitted by me is found to

be false, the admission of my son/ daughter would be cancelled.

Date: _____________________________

Place: Name and Signature of Parents

Contact No: