UNIVERSITY OF PORTHARCOURT

CURRENT SESSION./.

STUDENT UNDERTAKING FORM

SECTION A:
NAME OF STUDENT__________________________________________________________________ REGISTRATION/MATRIC NUMBER___________________________________________________ COURSE MAJOR__________________________ DEPARTMENT____________________________ FACULTY/COLLEGE_________________________________________________________________ Whereas I am aware of the Law restraining membership of secret cult in Rivers State and whereas I am a student of the University of Port Harcourt, I, .hereby pledge, on my honour not to be a member of a cult or secret society in this University or any other community in the State and Nation. I hereby agree that should it be reported and confirmed that I am a member of a cult, I should be dismissed from the University. ______________________________ SIGNATURE OF STUDENT ______________________ DATE

SECTION B: TO BE COMPLETED BY PARENTS I/We..the father/mother/guardian of ..hereby agree that my/our child should be dismissed from the University if at anytime it is reported and confirmed that he/she is a member of a cult. I/We accept the decision that any violation of this undertaking should lead to dismissal from the University alongside with due process of the Law. ____________________________________ SIGNATURE OF PARENTS/GUARDIAN ___________________________ DATE

SECTION C: TO BE COMPLETED BY THE COMMISSIONER FOR OATHS I CERTIFY that the UNDERTAKING above was both read aloud and signed by the student and the parents/guardian in my presence on the Day of ..200 _____________________________ COMMISSIONER FOR OATHS
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