DISCIPLINARY DECLARATION

I ______________________________ S/o / D/o. _____________________________ resident of

__________________________________ provisionally selected for Admission into Class ______, during the academic
year ____________ at St. Xavier’s C.C, Duddhi, Uttar Pradesh, do hereby solemnly affirm and state that I undertake to
abide by all rules and regulations of St. Xavier’s C.C, that are already in Vogue and that may come into force from time to
time. I further undertake to make it good if any loss sustained to St. Xavier’s C.C, Duddhi, Uttar Pradesh, due to my
negligence. I am aware that any involvement in any manner in the acts that break or contravene the rules & regulations
of St. Xavier’s C.C, Duddhi, Uttar Pradesh, attract punishment / disciplinary / suspension action. I further agree that any
disputes between the Management / Administration and students are subject to the Jurisdiction of School Laws.

Date: Signature of the Candidate

I, ________________________________Parent /Guardian of Mr. / Ms.__________________________ undertake to see

that my ward Mr. / Ms. __________________________________abides by all the rules & regulations of St. Xavier’s C.C,
Duddhi, Uttar Pradesh, as per the above declaration.

Date: Signature of the Parent / Guardian

(Relationship to be mentioned)

…………………………………………………………………………………………………………………………………………………

DISCIPLINARY DECLARATION
I ______________________________ S/o / D/o. _____________________________ resident of
__________________________________ provisionally selected for Admission into Class ______, during the academic
year ____________ at St. Xavier’s C.C, Duddhi, Uttar Pradesh, do hereby solemnly affirm and state that I undertake to
abide by all rules and regulations of St. Xavier’s C.C, that are already in Vogue and that may come into force from time to
time. I further undertake to make it good if any loss sustained to St. Xavier’s C.C, Duddhi, Uttar Pradesh, due to my
negligence. I am aware that any involvement in any manner in the acts that break or contravene the rules & regulations
of St. Xavier’s C.C, Duddhi, Uttar Pradesh, attract punishment / disciplinary / suspension action. I further agree that any
disputes between the Management / Administration and students are subject to the Jurisdiction of School Laws.

Date: Signature of the Candidate

I, ________________________________Parent /Guardian of Mr. / Ms.__________________________ undertake to see

that my ward Mr. / Ms. __________________________________abides by all the rules & regulations of St. Xavier’s C.C,
Duddhi, Uttar Pradesh, as per the above declaration.

Date: Signature of the Parent / Guardian

(Relationship to be mentioned)