dSfiVy fo”ofo|ky; Capital University

(Recognized by Govt. of India u/s 2(f) of the U.G.C. Act, 1956) (Recognized by Govt. of India u/s 2(f) of the U.G.C. Act, 1956)
Koderma, Jharkhand-825410, India Koderma, Jharkhand-825410, India

Lateral / Fresh Admission Admission Session

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Name of the Applicant in English as in the Birth Certicate or Marks Sheet of SSC Exam :

Name of the Applicant in Hindi as in the Birth Certicate or Marks Sheet of SSC Exam :

Mother’s Name :

(SC / ST /OBC / GEN)

Grade Point (GP)

/ ITI

Phone
Mobile No.
Ÿ I undestand that the fees once paid will not be refunded.
Ÿ I hereby tender that I will regularly a end the classes and will maintain atleast 80% a endance in my class.
Ÿ The eligibility documents submi ed by me are true and genuine to the best of my knowledge and belief.
Ÿ During the course of study Iwill not be in any kind of regular job either in any Govt., semi Govt. or Pvt. Authority/Co.
Ÿ During the course of study I will not do any other regular course from any other University.
Ÿ I will not indulge in any sort of legal cases, whether criminal/Civil during the course of study.
Ÿ I will not involve in malprac ce, misconduct, fraud in any manner during any tenure of study in the University.
I confirm that the informa on given on this form is true, complete and accurate and none of the informa on requested of other
material informa on has been omi ed. I accept if it is discovered that I have supplied false, inaccurate of misleading informa on,
Capital University reserves the right to cancel my applica on, withdraw its offer of a place or terminate a endance at the
Capital University and I shall have no claim against Capital University in rela on thereto.

Payment Details
DD No. DD Date Name and Address of Bank DD Amount