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(ANNEXURE-I)
UNIVERSITY COLLEGE
KURUKSHETRA UNIVERSITY KURUKSHETRA
(Established by the State Legislature Act XII of 1956)
(“A” Grade, NAAC Accredited)
STUDENTS INFORMATION
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(This form is to be filled completely by the candidate at the time of admission and is to be signed by the parents of
the students)
Name :________________________ Phone No. :________________________
Father’s Name :________________________ Phone No. :________________________
Mother’s Name :________________________ Phone No. :________________________
Class :________________________ E-mail ID :________________________
Roll No.
Dept./Institute
:________________________
:________________________
Paste Passport
size coloured
unattested
photograph
(Not to be stapled)
Do you reside in Hostel
Permanent Address
:(Yes/No)________________
(Mentioned the name of
Hostel, if yes)
:________________________
:________________________
:________________________
(Attach a copy of Ration Card/Pan Card/Aadhar Card in support
of the above address)
Phone No. of a person who is to be contacted in case of an Emergency
Blood Group
Whether your name exist in a voter list of any Assembly/Parliament
Constituency (If yes, attach copy of Voter Identity Card
:________________________
:________________________
:________________________
Dated :________________
(Signature of Student)
Declaration :
Certified that all the above information given by my ward are correct to the best of my knowledge.
Dated :_______________
(Signature of Father/Mother)
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