Last date for receipt of application Form :

(i) all Courses except (ii) below

: 29-06-2015
(ii) Certificate/Diploma Courses
: 15-07-2015

Sr. No. ..
Received on
Signature of receiver .

PANJAB UNIVERSITY, CHANDIGARH

Application form for Admission for All Courses (except for Ist Year Classes of the courses where admission
is based on JEE-2015, P.U.-CET-2015-(UG), PUTHAT-2015 & P.U.-B.A./B.Com. LL.B. (Hons.) Five Year
Integrated Course-2015 as the admission of these courses will be conducted online) for P.U., Chandigarh
and its Regional Centres at Hoshiarpur, Ludhiana, Kauni and Muktsar for the session 2015-2016
Panjab University Registration No./PUPIN (If any)

Affix
recent
Photograph of 3.5
cm. X 4.5 cm. duly
attested by the
Head
of
the
Institution last
attended

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1. Name of the department :_________________________________________

2. Class:__________________________ 3. Category code (see instructions) c c
4. Name of the Candidate
5. Fathers Name
6. Mothers Name
7. Guardians Name

cc cc cc cc
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8. Whether belongs to Economically Weaker Section

Yes/No

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10. Date of Birth c c c c c c 11. Sex c
M c
F TG
c 12. Nationality c c c c c c c c c c c c
13. Aadhaar Card No. c c c c
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9. Annual Income from all sources Rs.

14. Address for Correspondence

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Pin Code c c c c c c
Tel. No. c c c c c c c c c c
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15. Parmanent Address

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Pin Code c c c c c c
Tel. No. c c c c c c c c c c
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16. Are you claiming weightage on any of the following (Tick if Yes )
N.C.C. c N.S.S. c
Cultural activities c
Youth Welfare c
Passing last examination from P.U. c
17. Are you employed ?
Yes /No
18. Are you applying for hostel accommodation ?
Yes /No
19. Are you enrolled in or seeking admission to any course concurrently ? (If yes, give details)
Yes /No
20. Did you take admission in any of the departments of the Panjab University during the last three years ? Yes/No
Year
Deptt.
Roll No.
Result
If so, give year, department, roll number and the
(i) .....................
result of the university examination, if appeared
(ii) ....................
(iii)....................
21. Entrance Test Roll No. and Course
under which you appeared

Roll No........Course......Marks......
..
(Full Signature of the Candidate)

1.
2.
3.
4.
5.
6.
7.
8.

DECLARATION BY THE APPLICANT AND THE PARENTS/GUARDIAN

I declare that I have carefully read the instructions and state that the entries made by me in this form are correct to the best of my
knowledge and nothing has been concealed. I understand that my admission is liable to be cancelled if any of the statements made by me
above is found incorrect.
I undertake to observe proper standards of academic conduct.
I shall abide by the prescribed courses of reading and the modes of examinations, which may prevail from time to time, even though these
may be at variance with those of the previous years.
I shall abide by the rules and regulations as given in the Panjab University Calendars and its revisions/Handbook of Information and rules
for Admission.
I shall faithfully carry out the instructions issued by the Chairpersons of the Department, Faculty members and other University Authorities
from time to time.
I hold myself for due and prompt payment of fees and all other dues.
I understand that I cannot concurrently be enrolled for more than one full-time courses of studies.
I am fully aware that ragging is strictly prohibited/punishable under Law in the University. If I am found guilty of indulging in or abetting
ragging, I shall be liable for punishment and expulsion from the Hostel/University.

Dated : ..

..
(Full Signature of the Candidate)
I certify that my son/daughter/ward is making this application with my permission. I hold myself responsible for his/her good conduct and
behaviour as a student of the University and for payment of all his/her fees and dues during his/her stay in the Department.

Dated : ..

................
(Full Signature of the Parent/Guardian)
Name : ........
Address : ........
........

CERTIFICATE OF EMPLOYMENT
(Essential for Department of Evening Studies-MDRC and employees seeking admission to any other department)

I certify that I .......................................... s/o, d/o, w/o ............................................. has been

working as ................... in Govt./Semi-Govt./Private Organisation/Self employed (tick P) for the last ........ years.
I have obtained permission to join the said course and my emoluments are.............................................per month.

...................
Countersigned by the Employer

...................
(Signature of the Candidate)

Name and Designation (with seal)

Special Interests, if any
Mark (x) in the appropriate box/s :
(A)

Dance

Music

Acting

(B)

N.C.C.

N.S.S.

Hiking/Trekking

(C)

Blood Donation

Environment

(D)

Games : Specify..............................................................................................................................

Debate/Declamation

Leadership

Adult Education

Fine Arts

(Signature of the Candidate)

SUMMARY OF EDUCATIONAL QUALIFICATIONS FROM Xth CLASS ONWARDS

(Attested Photostat/Xerox copies of Detailed Marks Certificates and Degrees, etc., must be attested in support of statements)
Previous Exam.
Passed
Name of
Exam./Class

Subjects studied

Max.
Marks

Marks
obtd.

%age

Session
& Year

Roll No.

Uni./ Board

Name of
School/College

Aggregate of All University Examinations held during the B.Pharm. Course (attach details separately) and valid GATE-Score, if appeared.

(Signature of the applicant)

(CHECK-LIST OF DOCUMENTS ATTACHED (TO BE FILLED IN BY THE CANDIDATE)

University Certificates (List all the copies of certificates separately and make sure that the Detalied Marks Certificates of the examination) on
the basis of which admission is sought are included.
(i)
(ii)
(iii)
(iv)
(v)
(vi)
Total number of documents attached
Note : Incomplete application form or with wrong or deliberately concealed information is liable to be straight away rejected.

INSTRUCTIONS FOR CANDIDATES

1.
2.

3.

4.
5.

6.

7.
8.
9.

This form must be filled in by the candidate in his or her own hand in a clear and legible manner.
This application form complete in all respects must be submitted to the concerned Teaching Department/Centre of the Panjab University as
has been indicated in the Admission Notice of 2015-16 as well as in Handbook of Information and Rules for Admission 2015 on or before
the last date indicated at the top of application form, even if, result of the qualifying /Entrance examination has not been declared.
The application form must be completed in all respects. No column should be left unfilled. If any information sought is not applicable to the
candidate, the word N.A. should be entered against that column. If a candidate omits/conceals relevant information or gives false information,
his/her admission is liable to be cancelled.
All documents like copies of University Certificates, photographs, certificates claiming special status, etc. must be attached with this application.
In case the required documents are not attached, the application is liable to be rejected as incomplete.
The forms in which various certificates are to be submitted are given in the Handbook of Information. Only certificates along these lines
will be acceptable. Handbook of Information and Rules for Admission 2015 can be obtained from Sale Counter, Administrative Block
(Basement) Panjab University, Chandigarh, on cash payment of Rs. 550/- and by Post from the Manager, Publication Bureau, P.U.,
Chandigarh 160 014 against account payee Bank Draft of Rs. 660/- drawn in favour of the Registrar, Panjab University, payable at
Chandigarh.
All copies of University Certificates, photographs and character certificate, etc., must be attested by the Head of the Dept. last attended or by
a Class I Gazetted Officer or by an Officer of the University not below the rank of Assistant Registrar/Lecturer. The full name of the attesting
officer and the official seal must be clearly legible on the certificate.
The check-list of documents printed on this form should be carefully filled and the total number of documents enclosed with the application
should be clearly mentioned.
Foreign students should submit this Form to the concerned department through the office of the Dean of International Students, Panjab
University.
For filling item 3 category of the form use the following codes. ( One can fill more than one category) :Category

Code

Category

Code

General

GN

Military Personnel

Scheduled Caste

SC

(i)

Wards of Military/Paramilitary Personnel died in action

D1

Scheduled Tribe

ST

(ii)

Wards of Military/ Paramilitary Personnel incapacitated while in service

D2

Backward Classes

BC

(iii)

Wards of Military/ Paramilitary Personnel Ex-Servicemen

D3

*Sports Person

SP

(iv)

Defence Personnel incapacitated while in service

D4

Physically Handicapped/
VH/Blind
Terrorist Victims

PH

(v)

Wards of Serving Defence Personnel

D5

TV

(vi)

Ex-Servicemen

D6

Freedom Fighter

FF

(vii)

Serving Defence Personnel

D7

Kashmiri Migrant

KM

Foreign Nationals/NRI

NRI

One Girl child out of the

Only Two Girl children

OGC

Cancer, AIDS and Thalessemia Patient

Economically Weaker Section

CAT
EWS

*Candidates seeking admission in this category shall, along with the Admission Form, will submit following documents to the
concerned department and the concerned department will send the photocopy of the application forms after paging all the documents
received from eligible candidates to Directorate of Sports. The candidates are required to appear for trial in a proper sports kit
along with their original sports certificates on University Grounds as per schedule w.e.f. 15-7-2015 to 18-7-2015 (For Schedule
contact office of the University Director of Physical Education). Presence of candidate in the field at appointed time is Mandatory.
No separate intimation will be sent :(a) Self attested photocopies of sports certificates.
(b) Class 10th and class 10+2 and B.A. detailed marks certificate showing date of birth.
(c) Affidavit of sports achievement (ANNEXURE-III) available in HBI -2015 duly attested by a Notary/Magistrate class I/II on a stamp
paper of Rs. 5/- or 10/-.
(d) Roster form/list of players duly attested by the competent authority of concerned tournament/championship. The photograph of the
player should also be pasted on the certificate duly attested by the competent authority of concerned tournament/championship.
NOTES : 1.
2.
3.
4.

THE CANDIDATES SHOULD UNDERSTAND THAT THE ADMISSION IF GRANTED BY THE DEPARTMENT/CENTRE
WOULD BE PROVISIONAL AND SUBJECT TO CONFIRMATION BY THE DEAN OF UNIVERSITY INSTRUCTION.
FEES/FUNDS AND CHARGES PAYABLE FOR VARIOUS COURSES BY THE STUDENTS SHALL BE AS PRESCRIBED BY THE
SYNDICATE OF THE PANJAB UNIVERSITY, CHANDIGARH FROM TIME TO TIME.
HOSTEL SEATS ARE LIMITED AND THESE WILL BE ALLOTTED EXCLUSIVELY ON THE MERIT BASIS AS PER THE QUOTA
ALLOTTED TO THE DEPARTMENTS.
AT THE TIME OF ADMISSION, THE STUDENTS SHOULD SUBMIT AN UNDERTAKING THAT HE/SHE HAS NO CRIMINAL
BACKGROUND AND HAS NOT BEEN CONVICTED UNDER ANY CRIMINAL OFFENCE. HE/SHE SHOULD ALSO STATE IN
THE UNDERTAKING THAT NO F.I.R. IS REGISTERED AGAINST HIM/HER OR NO CRIMINAL PROCEEDINGS ARE PENDING
AGAINST HIM/HER AT THE TIME OF SUBMISSION OF APPLICATION. FURTHER, THE STUDENTS SHOULD ALSO STATE
IN THE UNDERTAKING THAT HE/SHE WILL NOT POSSESS/CARRYANY LETHAL WEAPON ON THE UNIVERSITY CAMPUS
AND IF ANY WEAPON IS RECOVERED FROM HIM/HER, HE/SHE BE RUSTICATED. (Syndicate Para 6, dated 29.3.2011)

In addition to attested copies of academic certificates, the candidate should also attach attested copies of the documents/certificates listed
below :(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
(i)

Certificates relevant to claim for a Reserved Category Seat.

Character Certificate.
No Objection Certificate from the Employer.
Migration Certificate.
Affidavit of or about not having been involved in any offence (required in case of a gap in academic career).
Eligibility Certificate.
Certificate in support of claim for weightage/weightages.
Foreign Nationals/NRI candidates are required to submit relevant Certificates.
Aadhaar Card.
E1/P.U.P. (481) 1500/15-05-2015