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AFFILIATED TO BANGALORE UNIVERSITY, APPROVED BY AICTE, NEW DELHI
No. 27/2, 33rd Cross,2nd Main Rd, 7th Block, Jayanagar, Bengaluru, Karnataka 560082
Date of Birth
X Std⁄ 10 Years/ Equivalent
PUC ⁄ Intermediate Higher Secondary 10 + 2 / Equivalent
Last Qualifying Exam Passed
Board ⁄ University Name
Month ⁄ Year
Optional ⁄ Group Subjects ⁄ Total Mark(All Years)
A + B
1.We hereby declare that we have read the contents of the prospectus and supplementary brochures of CITY College Jayanagar (CCJ) and have
understood the same in totality. Accordingly, we are seeking admission to CCJ on our own interest and accord.
2.I declare that all the information furnished in this application form is correct and to the best of our knowledge. If found to be incorrect or false,
I may be refused admission or debarred from the college. If admitted to CCJ, I agree to abide by the policies, bylaws, rules, and regulations of
the college, as amended from time to time. If found violating the college rules and discipline, I accept that my son/daughter shall be debarred
from the college and the decision of the college shall be conclusive and final in this regard.
3.My admission to the mentioned course is subject to approval of Bangalore University (BU). In case BU does not approve my admission for
want of required original certificates to be submitted by me within the last date and If I am not eligible due to non-recognition of my PUG /intermediate/10+2/Degree by BU or if I discontinue the course on my own, I fully understand that the fees paid will not be refunded by CCJ as the
college has already provided me the seat (otherwise the seat would have been allotted to another deserving student). Certificates submitted for
approval will not be returned to me as the certificates will be under the custody of Bangalore University until the course is completed. Fees applicable for my batch is to be paid for the entire course, irrespective of fees fixed for other batches.
4.We agree to the rule that deposits of any kind both at the college and hostel will be refunded only after the completion of the course and I will
not request for any refund, even if I withdraw admission or vacate the hostel room. I agree that the entire amount shall be forfeited under such
5.I declare that I shall not indulge in ragging, eve teasing, smoking, consuming alcohol, use of drugs or any other anti-social activities within the
college premises or otherwise, at hostel, on educational tours, industrial visits or elsewhere. I shall abide by the dress code prescribed by the
6.I understand that once I am admitted to the college, I am required to pay the entire fee in full for entire course at the time of admission. However, considering my request the college may agree to take fees in instalments. Since the seat has been provided to me, the same cannot be allotted
to any other prospective student at a later date, my discontinuation of study is a financial loss to the college. Hence, I have to pay full fee for all
the remaining years and collect my original certificates.
7.I also declare that I have not paid any donation or capitation in any form to the college against admission.
8.I understand that all information will not be sent to me by mail and I am required to pay the college fee, exam etc. by following college notice
board and fees to be paid as directed by the college. I understand that my name will be entered in the attendance register only after the payment
of fees in full and 80% attendance will be calculated for the university exams from the date of payment of fees.
9.I understand that it is my sole responsibility to submit my entire educational qualifying certificates or provisional degree certificate(Date of
Birth / Aadhar Card / Class 10th Marks Statement / Class 12th Marks Statement / Transfer Certificate / Migration Certificates / No Objection
Certificate/Eligibility Certificate in case of foreign students etc.., ) to the college at the time of admission itself.
Though the college may grant me provisional admission in the absence of some of the certificates on my promise of submitting them at a later
date, if all the required certificates are not submitted by me within 15 days of admission, my provisional admission shall automatically stand
cancelled and I shall not be entitled for any refund of fees paid by me as the college has already provided me a seat. I also understand that all
disputes, differences and legal matters are to be settled within the Bangalore City Jurisdiction only.
Parent’s / Guardian’s Signature