UNDERTAKING

I, the undersigned, hereby declare that I am enrolled in the academic year 2023-24 as a
student in the Class: FY/SY/TY/FoY, Branch: ____________ and fall under the admission
category of EBC/OBC/VJ/NT/SBC/SC/ST with Roll No: _______________. I am eligible for a
government scholarship/freeship to cover my tuition and development fees. I acknowledge that
failure to submit the Scholarship/freeship form by the specified deadline will result in the
obligation to pay the full tuition and development fees for the academic year 2023-24 to the
institute. In case of non-compliance, my admission to this institute for the AY 2023-24 will be
subject to cancellation.

Date:
Place:

Name of the Student:

Signature of Student:
Phone No of Student: