UNDERTAKING FORM
(BY THE STUDENT)
Photo
To,
The Dean Academics
Karnataka State Open University
Manasagangotri, Mysore
Karnataka - 06
Sir/Madam,
This is to declare that, I Son/Daughter
of have taken admission in programme in (January/ July) 20 _____
in Stream under Karnataka State Open University. And I assure that all the documents enclosed
related to my qualification regarding the admission are genuine and authentic.
I say and submit that I am under going programme of Karnataka State Open University, Mysore
to gain and enhance my knowledge and Academic value and I may not get advantage in teachings job.
I say and submit that to gain and enhance my knowledge and Academic value I want to Join
programme / academic course of Karnataka State Open University, Mysore and further advancement of my professional career.
In the event of suppression or distortion of any fact like educational qualification, documents related to nationality and study period etc. made in my application form, I understand that my admission is liable to be cancelled.
I am eligible for the examination as per the rules and regulations of the university. I shall be responsible for the consequences if the information filled by me is found incorrect. If I amfound ineligible for admission to a class, at any stage my application will be rejected even if my result has been finally declared and consequently such result also would be void.
I further say and submit that even if I do not get any advantage of said course after its completion, I hereby undertake not to hold the above University, its Institute or any other person responsible in any manner for getting no benefit of said course.
I say and declare that above course advanced by said University is only for enhancement of my knowledge and nothing more and with that clear understanding I joined the said course at my own risk and cost. I further say that I have gone through the prospectus of said University and I amfully satisfied with contents of the same. I also undertake not to claim any damage for the same.
Whatever is stated hereinabove is true and correct to my own knowledge and belief.
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Place :
Date : Enrollment No./Roll No.
Signature of the Candidate
UNDERTAKING BY THE STUDY CENTRE
This is to certify that Mr./Ms./Mrs
Son/ Daughter / Wife is a student registered from our Study Centre. The photo
pasted on this form depicts his /her current appearance correctly. I have personally checked all the documents enclosed
herewith. I attest that all the entries are correct. I, as well as the candidate, Know that if his/her result is finally not
declared due to ineligibility, I and the students shall bear fully responsible for rejection and not the University.
_______________________________________________________________________________
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Seal & Signature Of The Centre Incharge
Centre Code :
Document to be enclosed :
The applicant is required to enclose the attested photocopy of the following supporting documents :
1. Birth Certificate/Any Certificate showing date of birth.
2. Basic Qualification Certificates (Xth onwards)
3. Passing/Provisional Certificates.
Note :
(I) All documents in support of qualification must be duly attested by Notary only.
(II) All attested photocopiers have to be verified by the Director/Co-coordinator, Study Centre at the time of filling this
under-taking form.