Dr. Ram Manohar Lohiya National Law University Sector D-1, LDA, Kanpur Road Scheme, Lucknow-226012 Enrollment/Admission Form PG Diploma in Cyber Law Programme, 2015-16 The Admission Form, duly filled in, shall be submitted to the office of Dr. Ram Manohar Lohiya National Law University, Lucknow within the last date notified. Irregular or incomplete form will not be entertained. Any Misrepresentation or fraudulent information shall lead to the cancellation of the admission of the candidate at any stage. (To be filled in by the office) Date of Admission... Course... Enrollment No... Affix Passport size recent photograph (To be filled in by the applicant in his/her own handwriting) 1. Name of the applicant in Block Letters (as appears in the High School Certificate) 2. a) Father's name and occupation b) Mother's name and occupation 3. Guardian's name, occupation and relationship with the applicant 4. House No... Sector/Ward/Village...... P.O... District... a) Father's/Mother's/Guardian's present address State... PIN... Tel.No... E-mail ID:... b) Parent's permanent home address House No... Sector/Ward/Village...... P.O... District... State... PIN... Tel. No... E-mail ID:... PAGE 1 of 3 P.T.O.
House No... c) Address for Correspondence Sector/Ward/Village...... 5. Nationality 6. Gender: Male/Female /Transgender P.O... District... State... PIN... Tel.No... E-mail ID:... 7. Whether lives in Urban/Rural area? 8. Whether a domicile of Uttar Pradesh? Yes or No 9. Whether belongs to S.C./S.T./O.B.C./ P.H. Category of U.P.? If yes, specify 10. Whether belongs to Physically Handicapped category? If yes, specify: Orthopaedic/ Visual/Hearing impiarment 11. Name, address, telephone no. and E-mail ID of House No... the Local Guardian, if any Sector/Ward/Village P.O... District... State... PIN... Tel.No... E-mail:... 12. a) Date of Birth(as per High School Certificate) b) Place of Birth c) Age of the applicant (as on 1 st July, 2015) 13. Blood Group of the applicant 14. Marital Status: Married/ Unmarried PAGE 2 of 3 P.T.O.
15. Examination Passed (High School or equivalent Examination onwards) Sl. Name of Examination Year of Name of the Board/ Subjects offered Division/ % of No. Passing University Position Marks 1. 2. 3. 16. Whether the applicant is pursuing any other course of study or in service? If yes, give details of the course and the Institution/Department 17. Whether the applicant participated in Cocurricular activities and sports. If yes, give Details 18. Approximate annual income of the family from all sources. 19. Whether the applicant had been rusticated by any Educational Institution or any Penalty is imposed for violation of the law of the land. 20. Any other remark, if any (Full name) I...hereby declare that the statements made by me as above are correct. I shall abide by all the Rules and Regulations framed by the University from time to time. I understand that in case any information furnished by me is found to be incorrect, my admission to the course shall be liable to be cancelled. Date... 2015 Signature of the Applicant... Place... N.B.:- Duly attested photocopies of all the original documents and certificates are to be attached herewith. For Office Use Only Provisional Admission granted (Programme Director) PG Diploma in Cyber Law Programme PAGE 3 of 3
Dr. Ram Manohar Lohiya National Law University, Lucknow Undertaking by the Candidates I,...S/o D/o... candidate for admission to... is aware of the fact that RAGGING in any form, within or outside the educational institution is a criminal offence and prohibited under law and as per rules any student found indulging in ragging shall be expelled from the University and a FIR will be lodged against him for necessary action. I have read all the terms & conditions of the provisional admission and agree to abide these terms & conditions in my academic interest. I have received a copy of hostel rules and Library rules and have gone through it and undertake to abide by it. I am aware that keeping vehicle in University premises is not allowed and carrying and displaying of ID card while in campus is necessary in the interest of my security. I hereby undertake that I shall neither indulge myself nor instigate any other student in ragging or create nuisance in the hostel and University premises and shall not vitiate the academic atmosphere of the University in any manner. In case I am found indulging myself in any act amounting to violation of discipline or misconduct or in the acts falling under the definitions of Ragging, or breach of above undertaking, action be taken against me as per rules. Date: Signature of the Candidate *Ragging within or outside the educational institution is prohibited. Ragging includes display of noisy, disorderly conduct, teasing, rough or rude treatment indulging in rowdy, undisciplined and obscene activities which cause or are likely to cause annoyance; undue hardship, physical or psychological harm or mental trauma or raise apprehension or fear in a fresher or other students, or forcing a student to do any act which such a student is not willing to do or which causes him/her shame or embarrassment or danger to his/her life or limb, or indulging in eve teasing. **********
Dr. Ram Manohar Lohiya National Law University Sector D-1,LDA,Kanpur road Scheme, Lucknow-226012 Name of Students : Course & Semester : PGDCL Programme Form for the Proctorial Board Affix your Recent passport size photographs Blood Group :... S.No. Name and Address Mobile No. Land Line No. E-mail ID Name: 1. Student Address: Name: 2. Father Address: Name: 3. Mother Address: Name: 4. Local Guardian Address: Date: / / 2015 Signature of the Student
f/k ksgjy jkeeu ksfg;k Mk0 y[kuå jk V fo ofo ky; ªh; fo Mk0 jke euksgj yksfg;k jk"vªh; fof/k fo'ofo ky;] y[kuå Dr. Ram Manohar Lohiya National Law University, Lucknow (USE CAPITAL LETTERS ONLY) Dr. Madhu Limaye Library, Lucknow ID-CARD/ LIBRARY REGISTRATION FORM Fix your Ticket size photograph Last Name: First Name: Middle Name: Father s Name: Enroll. No. (To be filled by the Office) D.O.B. ------------------------- Blood Group-------------------------- Member Type: - Course Name (If Student):- Sem/Year: Designation (if employee) Permanent Address : Pin Code: Contact No. (Office): Contact No. (Residence): Personal Mobile No. E-mail: I have gone through all the rules and regulations of the library. I hereby agree to abide all of them. (Signature of the User) Recommendations of Programme Director: I recommend the above named person to avail the library facilities. Valid from: Till: Signature with seal: Date: For Office use only Library ID Given: Library ID created by (Name & Sign): Date: (Librarian In-charge)
e f k k g sf y j s k u e k j 0k Ty M [ k u Å k V hª ; f o y ; k o f / k f o o Dr. Ram Manohar Lohiya National Law University Sector D-1, LDA, Kanpur Road Scheme, Lucknow-226012 Student s Copy Receipt of Admission Received one Admission form, from Sri/Smt../Km...... S/o/D/o......... for Provisional Admission in the PG Diploma in Cyber Law Programme, 2015-16. Date :... Authorized Signatory Seal of the Office...
Date:... To, The Programme Director, PG Diploma in Cyber Law Programme, Dr.Ram Manohar Lohiya National Law University, Lucknow-226012 Subject: Undertaking for documents Sir, Due to some unavoidable reasons, I am not able to submit the following document(s):- 1.... 2.... 3.... 4.... 5.... I undertake to submit the same within 10 days from the date of provisional admission. Yours sincerely,
To, The Warden in Chief, Dr.Ram Manohar Lohiya National Law University, Lucknow. Subject: Request for allotment of room in the University s Hostel Sir, I am student of PG Diploma in Cyber Law programme. In order to pursue my studies, I need accommodation in the University s Hostel. I hereby undertake to abide by all the rules and regulations of the University relating to Hostel. Thanking you, Date: Your Sincerely Signature : Name : Remarks : Programme Director, PG Diploma in Cyber Law Programme. (If any)......
Application Number [For office use only] DR. RAM MANOHAR LOHIYA NATIONAL LAW UNIVERSITY, LUCKNOW APPLICATION FOR ADMISSION TO PG DIPLOMA IN CYBER LAW To be filled by the candidate Affix passport size recent photograph 1. Full name of the Applicant (In Block Letter) 2. Name of the Father/Mother/Guardian 3 Personal Details Date of Birth Place of Birth Nationality (Please Specify) : Day Month Year Town/ Village District State Marital Status Married Unmarried Gender Male Female T.G. Category (UR/SC,ST & OBC of U.P.) (Attach Certificate, if applicable ) Address for correspondence Permanent Address PIN:... Email:... Tele Phone No. (with STD code) (Res):... Tele Phone No. (Mob):... PIN:... Email:... Tele Phone No. (with STD code) (Res):... Tele Phone No. (Mob):... 4. Educational Qualification (Attested copies of the certificates/mark sheets to be enclosed) Examination Passed HSC (10 Level) or Equivalent H.S. (10+2 Level)or Equivalent University/Institute Year Discipline Subject Division/ Class % of Marks/CGPA Remarks UG or Equiv PG or Equiv Any other
5. Any fellowship/scholarship (Attach additional sheet, if necessary) : Name of Organization type of Fellowship/scholarship Date of Award Duration of Award Discipline Remarks 6. Experience, if any, of Service, Teaching and/or research including present position held: (Attach additional sheet, if necessary) Name and address of employing organization Designation From To Total period up to date Nature of work Salary Drawn Remarks 7. Payment of Application Fee Name of the Bank DD Amount Rs... DD No.... Payable at Date.. Declaration by the Applicant : I hereby declare that all the particulars furnished are correct. I am aware that any incorrect information may lead 8. to cancellation of my admission/selection. If selected for admission, I promise to abide by the rules and regulations of the University. Date Place Signature of Applicant LIST OF ENCLOSURES (Attach additional sheet, if necessary) 1. 6. 11. 2. 7. 12. 3. 8. 13. 4. 9. 14. 5. 10. 15. Useful information for filling up the form 1. Enclose copies of all the relevant certificates/ mark sheets etc. (both sides). 2. A Self addressed and stamped envelope of 28 cm x 12 cm size should be enclosed. 3. The candidate must possess the requisite qualification on the date of Application. 4. Application incomplete in any respect is liable to be rejected. 5. Applications shall be submitted to the office of the Registrar, Dr. Ram Manohar Lohiya National Law University, Lucknow 226012 6. Application received after August 10, 2015, will not be entertained. 7. The candidates may see the Merit list on the University Website. 8. The candidate is required to pay Application fees by a Demand Draft (Rs500/ for Unreserved & OBC of UP & Rs. 250/ for SC/ST of UP) drawn in favour of DR.RAM MANOHAR LOHIYA NATIONAL LAW UNIVERSITY, payable at LUCKNOW. 9. An application without Application fees shall be rejected. For Office Use Only The Candidature Approved/Rejected Authorized Signatory