Admission FORM CLAT-2022

Dr.
Ram Manohar Lohiya National Law University

Sector D-1, LDA, Kanpur Road Scheme, Lucknow-226012
Admission Form
B.A. LL.B. (Hons.)/LL.M. Programme, 2022-23
(The Admission Form, duly filled in, shall be submitted to the office of Dr. Ram Manohar Lohiya National Law University, Lucknow
through online mode before last date. Incomplete Forms will be summarily rejected. Any Misrepresentation or furnishing fraudulent
information, at any stage shall lead to cancellation of admission of the candidate.)
(To be filled by the office)
Date of Admission...................................................
Class......................................................................... Affix Recent
Passport Size
Enrollment No.......................................................... Color
CLAT-2022 All India Rank..................................... Photograph
Candidate's Signature
Category Rank if any................................................
(To be filled by the Candidate in his/her own handwriting)

1. Name of the applicant in Block Letters
(as appears in 10th Passing Certificate)
2. a) Father's Name
Occupation
Qualification
Mobile Number
b) Mother's Name
Occupation
Qualification
Mobile Number
3. a) Nationality
b) Gender: Male/Female/Transgender
c) Marital Status: Married/Unmarried
d) Date of Birth (as per 10th Passing Certificate)
e) Place of Birth
f) Blood group of the applicant
g) Age of applicant (as on 01st July, 2022)
h) Candidate's Mobile Number
4. a) Permanent address House No...........................................................
Sector/Ward/Village..........................................
P.O.....................................................................
District...............................................................
State ..............................PIN..............................
Tel. /Mobile No..................................................
E-mail ID..........................................................
b) Address for Correspondence House No...........................................................
P.O.....................................................................
District...............................................................
State ..............................PIN..............................
Tel. /Mobile No..................................................
E-mail ID............................................................
5. Local Guardian's Name
Occupation
Relationship with the Candidate
Address House No...........................................................
P.O.....................................................................
District...............................................................
State ..............................PIN..............................
Tel. /Mobile No..................................................
E-mail ID............................................................
Page 1 of 4
Dr. Ram Manohar Lohiya National Law University
6. Details of Examination(s) Passed:
(High School or equivalent Examination onwards)
S. Name of the Year of Name of the Grading System/ Division/ %age of
No. Examination Passing Board/ Subjects studied Marking System Grade Marks
University
1.
2.
3.
7. Place of Residence (Urban/Rural)
8. Domicile (State)
9. Whether the candidate belongs to S.C./S.T./O.B.C./EWS
Category of UP or Foreign National/NRI/NRI
Sponsored/Residents of Jammu & Kashmir Category? If
yes, specify
10. Whether the candidate belongs to the category of Loco-motor disability
“Specially Abled Person (SAP)”? If yes, please specify the Visual impairment
kind of disability: Hearing impairment
11. Whether the candidate belongs to 'Dependants of Freedom
Fighters' of U.P.?
12. Whether the candidate belongs to the category of
'Sons/Daughters of Defence Personnel deployed in Uttar
Pradesh or Defence Personnel of Uttar Pradesh either
retired or killed/disabled in action'?
13. Whether the candidate is pursuing any other course of
study? If yes, give details of the course and the Institution.
14. Whether the candidate has participated in Co-curricular and
sports activities. If yes, give details
15. Annual income of the parents from all sources.
16. Whether the candidate has faced any disciplinary
proceeding or has any Penalty/Punishment been imposed
for violation of the law of the land.
17. Any other relevant information
I ..........................................................................hereby, declare that the above statements made by me are correct.
(Full name of the candidate)
I shall abide by all the rules and regulations enforced by the University from time to time. I understand that in case,
any information furnished by me is found to be incorrect; my admission to the course is liable to be cancelled.
Date: ___/___/2022 Signature of the Candidate................................................................
I...................................................Father/Mother/Guardian of.............................................................................hereby,
undertake that my ward shall abide by the rules and regulations of the University, failing which the University may
take any action against him/her.
Date: ___/___/2022 Signature of the Parent/Guardian..................................
Place.......................
Note: Duly attested photocopies of all the relevant documents and certificates are to be attached.
For Office Use Only

Provisional Admission granted.
(Chairperson)
Admission Committee
Page 2 of 4
Undertaking by the Candidate
I, .......................................................................... S/o / D/o ................................................................... a

candidate for admission in B.A. LL.B. (Hons.)/ LL.M. Ist Semester, undertake that if any discrepancy is
found later on the physical verification of original documents, my provisional admission shall stand
cancelled.
I am also aware of the fact that RAGGING in any form, within or outside the educational institution is a
criminal offence and prohibited under law and as per rules any student found indulged in ragging shall
be expelled from the University and an FIR will be lodged against him/her under relevant provisions
of Law.
I have read all the terms and conditions of the provisional admission and agree to abide by these terms and
conditions in my academic interest. I have gone through the hostel and Library rules and undertake to
abide by them. I am aware that keeping vehicle in the University premises is not allowed. Carrying and
displaying of ID card while in campus is necessary in the interest of my security. I hereby undertake that I
shall neither indulge nor instigate any other student(s) for ragging or create nuisance in the hostel and
University premises and shall not vitiate the academic environment of the University in any manner.
In case I am found indulged in any act amounting to violation of discipline or misconduct or in the acts
falling under the definition of Ragging, or breach of above undertaking, action be taken against me as
per rules.
Date:___________ Signature of the Candidate
Declaration by Parent/Guardian
I ......................................................., Father/Guardian of Mr./Ms. .................................a candidate for

admission to/student of class....................................................................., at Dr. Ram Manohar Lohiya
National Law University Lucknow, am aware of the law in regard to ragging and maintenance of
discipline. I agree to abide by the punishment meted out to my ward in case he/she is found involved in any
act of misconduct, indiscipline, or ragging in the hostel/premises of the University. Afore mentioned
undertaking would be binding on me until my ward is a student of Dr. Ram Manohar Lohiya National Law
University, Lucknow.
Date: _____________________ Signature of Parent/Guardian

Place: _____________________
Contact Nos.
Cell No.:_______________________
Land Line No.:__________________
*************

Ragging within or outside the educational institution is prohibited. Ragging includes display of noisy, disorderly conduct,
teasing, rough or rude treatment indulging in rowdy, undisciplined and obscene activities which cause or are likely to cause
annoyance; undue hardship, physical or psychological harm or mental trauma or raise apprehension or fear in a fresher or
other students, or forcing a student to do any act which such a student is not willing to do or which causes him/her shame
or embarrassment or danger to his/her life or limb, or indulging in eve teasing.
Page 3 of 4
Form for the Proctorial Board

(To be filled in capital letters)
Name of the Student : .............................................................................

Class & Semester : ............................................................................. Affix recently
passport size
Blood Group : ............................................................................. photograph
S.N. Persons Name and Address Mobile No. Land line No. E-mail ID
Name:
1. Student Address:
Name:
Address:
2. Father
Name:
Address:
3. Mother
Name:
Address:
Local
4.
Guardian
Date: / / 2022 Signature of the Student
Page 4 of 4

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Dr.

Ram Manohar Lohiya National Law University

(To be filled by the Candidate in his/her own handwriting)

For Office Use Only

I, .......................................................................... S/o / D/o ................................................................... a

Date:___________ Signature of the Candidate

I ......................................................., Father/Guardian of Mr./Ms. .................................a candidate for

Date: _____________________ Signature of Parent/Guardian

Form for the Proctorial Board

Name of the Student : .............................................................................

Date: / / 2022 Signature of the Student

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