12. Particulars of previous and the last Examination passed.

Last Examination Appeared / Passed

Name of School/College

Year of Appearing/Passing

Result Awaited/Declared  (Fill in Which is Appropriate)

UNDERTAKING

I hereby declare and certify that the particulars given by me above and anywhere in the forms are correct and authentic.
I also certify that I have read all the rules and regulations in the Polytechnic and I shall abide by them. I understand that any payment (including those of fees) will not be refunded by the Polytechnic. This is regardless of whether I join or do not join after securing admission or discontinue during a term.

______________________                                                                                                             _______________________________
Signature of Student                                                                                                                               Counter Signed by Parent/Guardian

UNDERTAKING-2

I ___________________________________hereby declare without reservations That I as the responsible parent/guardian of of any kind______________________________will not seek to hold Mrs. Ashima Chaudhuri nor anyone employed by her, assisting her or connected in anyway with her Polytechnic responsible for/in any mishap to the student named above. This includes while at / proceeding to / from her Polytechnic in the Chartered Bus/or otherwise.

........................................................                                                                                                      Address  ...............................................................
Signature of Student                                                                                                                                           ................................................................
                                                                                                                                                                              ................................................................
                                                                                                                                                                              ................................................................
........................................................                                                                         
Signature of Parent/Guardian                                                                                                          Telephone Numbers..............................................

The following requirements must be attached along with the application form:

(i)   A Registration Fee of Rs. 500/-
      (This must be in the form of Cash/Bank draft only. No postal order is acceptable.)
(ii) One set of attested Photostat copies of certificates and mark sheets of examinations passed.       (Originals are not required.)
(iii) A self-addressed envelope with Rs. 5/- postal stamp.
(iv) Four passport size photographs are required for:
  i) Admission Form       ii) Identity Card        iii) Two photos for the Admit Card.

KINDLY NOTE:

•Please do not enclose originals of any documents. Only attested photostat copies of originals must be submitted. In case of any difficulty in attestation you may bring along your originals. Our Admission Officer therewith shall on the spot attest the document for you.
•The Certificates / Diplomas from South Delhi Polytechnic for Women are not recognized by the Govt. of India, State Govt.,  U. G. C. & All India Council for Technical Education.

There will be a charge of Rs.150/- at the time of submission of downloaded forms for admissions.

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