DECLARATION

I SOLEMNLY UNDERTAKE to accept and abide by the rules of the Jamia Millia Islamia and all the decisions of the
Admission Committee and other appropriate University bodies in regard to my admission.
I SOLEMNLY AFFIRM that I have never been convicted by a court of law nor rusticated/expelled from any educational
institution nor disqualified/debarred from any examination.
I will accept the cancellation/forfeiture of my candidature in case any information supplied by me in this form is found to be
incorrect at the time of admission or thereafter.
..................................
Signature of the Applicant

Date...................................

DECLARATION BY THE PARENT/GUARDIAN

I certify that the above particulars are correct. I agree that in the event of my son/daughter/
ward............................................................. being admitted to the Jamia Millia Islamia, New Delhi, I shall pay dues
and all personal expenses until the completion of the applicants studies. I also undertake full responsibility for the good
behaviour and conduct of the applicant.

Date..............................

..........................................................
Signature in full of the Parent/Guardian
Relation with student.....................................................
Address.......................................................................
...................................................................................
Telephone No................................................................
E-mail..........................................................................

INSTRUCTIONS
1. Code for Category:
G
MO
J

General
Muslim OBC
Jamia*

M
MT
K

Muslim General
Muslim ST

MW
PD

Muslim Women
Persons with Disabilities

Kashmiri Migrant

* Jamia as category of reservation shall only be applicable to courses for which qualifying examination is obtained
from Jamia Schools as provided in Jamia rules.
No change of category is permissible, once the choice has been made.
2. In case of downloaded Application Form a Bank Draft/Pay order (of a bank having its branch in New Delhi) should be
made in favour of Jamia Millia Islamia, payable at New Delhi. Candidate must write his/her name and number of his/
her Application Form on the back of the bank draft/pay order/cash receipt on top left conrner.
3. Filled Application Form complete in all respect along with the Bank Draft/Pay order, should be submitted in the office
of the Dean of the respective Faculty/Department/Centre by the last date indicated in the Prospectus.

FOR CENTRE

JAMIA MILLIA ISLAMIA

Form No.

Jamia Nagar, New Delhi-110025

Admit Card for Entrance Test 2013-2014

Roll No.
(To be filled by the office)

Course applied for: ................................................. Dept./Faculty .............................

Name (In Block Letters):......................................................................................................
Fathers Name:.............................................................................................................
Mothers Name:.............................................................................................................
Address:........................................................................................................................

Affix your recent

self attested coloured
photograph
(Size 2.0 x 1.5)
It should be pasted with gum
and covered with

.......................................
Signature of Applicant

.......................................
Signature of Invigilator

FOR CANDIDATE

transparent tape

Cut Here

JAMIA MILLIA ISLAMIA

Form No.

Jamia Nagar, New Delhi-110025

Admit Card for Entrance Test 2013-2014

Roll No.
(To be filled by the office)

Course applied for:................................................. Dept./Faculty .................................

Name (In Block Letters) : ..........................................................................................................
Fathers Name:..................................................................................................................
Mothers Name:.................................................................................................................

Affix your recent

self attested coloured
photograph
(Size 2.0 x 1.5)

Address:............................................................................................................................It should be pasted with gum

and covered with
transparent tape

.......................................
Signature of Applicant
Note:

.......................................
Signature of Invigilator

Contact the Concerned Dept /Faculty for venue of Entrance Test.

Cut Here

Acknowledgement Slip

Form No.

Received an Application Form from (Candidates Name) ............................................................ for admission

to ................................................................................................course.

Date.................................

...........................................................
Signature of receiving official with Stamp