UNIVERSITY OF DELHI

(DELHI)
Regn. No._________
Application Form for Registration of the Children/Widows of the Officers and Men of the
Armed Forces including Para-Military Personnel, Killed/Disabled in action or those who
were died/disabled on duty, Gallantry Award Holder for admission to Four Year Under-
graduate Programmes (Discipline-I, Major) for the Academic Session 2014-2015.

1. Name of the Candidate__________________________________________________

(in Block letters)
Affix a self-
2. Sex (Male/Female)_______________________________________________________ attested latest
passport size
photograph
3. (i) Date of Birth (in figures) _____________________________________________
(ii) Date of Birth (in words) ______________________________________________
_______________________________________________________________________

4. Father’s Name_______________________________________________________________________________

5. Mother’s Name______________________________________________________________________________

6. Permanent Address__________________________________________________________________________
_____________________________________________________________________________________________

7. Local/Postal Address________________________________________________________________________
_____________________________________________________________________________________________

8. Telephone No. (if any)______________________________________________________________________

9. a) Whether admission taken in DU in previous year(s): Yes/No

b) If yes, state College_______________________________Course_____________Year_________
Result: Passed/Failed/Absent

TICK MARK THE CATEGORY TO WHICH THE CANDIDATE BELONGS:

I. Killed in action
II. Serving personnel & ex-servicemen disabled in action
III. Personnel died in peace time with death attributable to military service
IV. Disabled in peace time with disability attributable to military service
V. Gallantry Award Holder

DETAILS OF 10+2 EXAMINATION PASSED

Examination Board/ Roll Year Subjects Max. Marks % age

passed Univ. No. Marks Obtd. of Marks

Total Marks of (1 Language + 3 Total Marks of P.C.M. (Phy., Total Marks of P.C.B. (Phy.
best Elective Subjects) (Out of 400) Chem., Math) (Out of 300) Chem., Bio.) (Out of 300)

Dated: __________________ Signature of the Candidate

P.T.O.
 UNDERTAKING
I undertake that the information and documents furnished by me in my application are
correct. In case any of the information/documents given by me is found to be false at any
stage, I will be liable to face DISCIPLINARY ACTION in accordance with the University rule,
including CANCELLATION of my admission to the course concerned.

Dated: __________________ Signature of the Candidate

FOR OFFICE USE ONLY

The particulars mentioned by the candidate have been checked and verified with the Original
Certificates of the candidate.

Dated: __________________ Signature of Dealing Assistant

DOCUMENTS TO BE ENCLOSED
Self attested copies of the following:

(i) Certificate of Educational Concession from any of the following authorities on

the proper letter head (format of the certificate is given below)

 Secretary, Kendriya Sainik Board, Delhi.

 Secretary, Rajya Zila Sainik Board.
 Officer-in-Charge, Record Office.
 1st Class Stipendiary Magistrate.
 Ministry of Home Affairs (For Police Personnel in receipt of Gallantry
Awards)
(ii) Statement of Marks (Class XII)
(iii) Provisional Certificate (Class XII)
(iv) Date of Birth Certificate (Class X)

 Produce Original Certificates at the time of Registration.

 The Certificates be attached in the above order.
 The Original Certificates to be returned after verification/endorsement at the time of
Registration.

FORMAT
(ON THE PROPER LETTER HEAD)
OFFICE OF THE________________
EDUCATIONAL CONCESSION CERTIFICATE
This is to certify that Master/Miss______________is son/daughter of ___________(No._______)
resident of ________________________________.

The above named Officer/JCO/OR_________________________________:-

I. Killed in action on __________ during ________

II. Disabled in action on_______ during ________
III. Died in peace time on duty on ________ with death attributable to military services.
IV. Disabled in peace time on duty with disability attributable to military service.
V. Gallantry Award: __________.

Master/Miss__________son/daughter of_________ Officer/JCO/OR is eligible for educational concession

for admission in University of Delhi against the Armed Forces quota under Priority_______.

No.:_____________
Date:____________
(Signature)
Rubber stamp with Name & Designation

NOTE:-
1. Incomplete applications shall be rejected without any notice to the candidates.
2. 5% of the seats in each course have to be offered to the Children/Widows of Officers
and Men of the Armed Forces including Para-Military Personnel, in the following
order of preference:
I. Widows/Wards of Defence personnel killed in action;
II. Wards of serving personnel and ex-servicemen disabled in action;
III. Widows/Wards of Defence personnel who died in peace time with death
attributable to military service;
IV. Wards of Defence personnel disabled in peace time with disability
attributable to the military service; and
V. Wards of Ex-servicemen personnel and serving personnel including personnel
of police forces who are in receipt of Gallantry Awards;
Gallantry Awards include: Param Vir Chakra, Ashok Chakra, Sarvottam Yudh Seva Medal,
Maha Vir Chakra,Kirti Chakra,Uttam Yudh Seva Medal,Vir Chakra,Shaurya Chakra,Yudh
Seva Medal ,Sena, Nau Sena,- Vayusena Medal, Mention-in-Despatches, President’s Police
Medal for Gallantry, Police Medal for Gallantry.
3. A concession of 5% marks in the minimum eligibility requirements prescribed by the
University for admission of general category candidates to various courses will be
extended to the candidates. For example, if the minimum eligibility for applying for
admission to a course for the General Category candidates is 45% marks in class XII, it
will be 40% in the case of CW category candidates. For details, the candidates should refer
to the Four Year Undergraduate Programmes: Admission Brochure-2014-2015.
******
 UNIVERSITY OF DELHI
(2014-2015)

Name:

Registration No.__________
OPTION FORM
GIVE THE ORDER OF PREFERENCES FOR COURSES (Discipline-I, Major) AND
COLLEGES

CHOICE NAME OF THE COURSE NAME OF THE COLLEGE

(Discipline-I, Major)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.

Dated : __________________ Signature of the Candidate

 UNIVERSITY OF DELHI
REGISTRATION SLIP
(FOR WARDS OF ARMED PERSONNEL CATEGORY)
(2014-2015)

Regn. No._________

Received an application/registration from Sh./Km./Smt.__________________

Affix a self
_____________________________ for registration for admission to the 1st year attested
latest
passport
_______________________Course (Discipline-I, Major). size
photograph

Dated______________ Signature of Dealing Assistant

___________________________________________________________________________________________________