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WITHDRAWAL FORM

I withdraw my candidature of my own free will from election to the Student Member of
Internal Complaints Committee (ICC) of the University of Delhi 2018-19.

Name _________________________________ Son/Daughter of ______________________

Course _____________________Subject _________________________________________

Department/Institute/ Centre ___________________________________________________

Resident of _________________________________________________________________

Telephone/Mobile No.____________________ E-mail: ______________________________

Dated: _________________ ___________________________


Signature of the Candidate withdrawing

Note: The letter of withdrawal shall be submitted by the candidate in person along with a
copy of self-attested Identity Card issue by Department/Institute/Centre of the
University of Delhi to which he/she is enrolled in.

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