UNDERTAKING BY THE STUDENTS

I (full name/admission number) Ms.____________________________________________ D/O C/O

_____________________________________________ joined for GNM Course during 2022 to 2025 academic year
in Mata Padmawati College of nursing. Nahan

Do here by undertake & abide by the following rules & regulations:

1. It shall be my responsibility to keep myself well versed with the provisions, rules, regulations, ordinances
etc. of the college, & college shall not be responsible for informing me separately.
2. The college will be at liberty to impose any penalty or any disciplinary action(s).on me being found guilty
of any sort of misconduct or indiscipline within or outside the precincts of the college, or any act which is
determinable to the interest of college or university both. The college, in such stage can discontinue my
stay in the college & I shall not be entitled for any refund of admission fee, hostel fee, bus fee/ or any other
fee/ charges paid to the college& I shall also be liable to pay the pending fee, dues, penalty, etc.
3. I shall study at the college for the complete duration of the program opted for & due to any reason, I
leave/withdraw at any time before the completion of the program, I shall be liable to pay the fee for all the
successive terms & other pending dues (for the full academic year), if any.
4. Cancelation of admission will be permitted before the last date of admission. Refund the full fee less than
Rs. 1000 after commencement of the course, if the seat is filled by another candidate.
5. I will pay tuition fee, examination fee & other dues with on the stipulated times as required by the
institution authorities failing which I will not be permitted to attend the classes.
6. I will attend all the classes from the re-opening day of the college as per the time table, failing which I am
liable to pay a fine, I shall be aware that without attendance I am ineligible to continue for the current
academic year
7. I will be regular & punctual to all the classes (theory/practical) & secure attendance of not less than 80
hours for theory & 100% attendance for practical. I am fully aware that attendance less than 80 hours &
100 % in practical classes will make me lose one year.
8. I will compulsory follow the dress code & uniform prescribed by the college.
9. I will conduct myself in a highly disciplined & decent manner both inside the classroom & in the campus,
failing which suitable action may b taken against me as per the rules & regulations of the college.
10. I will concentrate on my studies without wasting time in the campus/hostel/residence & attendthe entire test
to secure more than the minimum prescribed class/ sessional marks in each subject. I will submit the
assignments given in time to improve my performance.
11. I will not bring mobile phone to the college campus & I will not involve in any kind of ragging inside or
outside the campus. I am fully aware that bringing mobile phone in the campus& involving in ragging is an
offence & punishable as per Supreme Court rules/laws.
12. I shall be liable to pay any damage caused by me to the property of the college either alone or jointly with
others& face disciplinary action, as per rule.
13. I am medically fit & don’t have any communicable or serious disease like that of fits or sort of attacks or
otherwise I shall reliable to pay for any expenditure incurred by the college or my treatment for any illness
or disease or any personal injury or otherwise due to any reason during the course of my study at the
college.
14. I shall not possess, sell, lest to lire, distribute, publically exhibit or any manner put into circulation any
obscene material. For the purpose of this cause,”Obscene Material” will have the same meaning as defined
in various statutes, applicable from time to time & as interpreted by the Hon’ble Court of India.
15. I shall not possess, use or deal with any kind of intoxicating material including alcohol, drugs of any kind,
gutka, tobacco, cigarettes or any other sedative material & on being found guilty, the college may take
disciplinary action(s), including rustication/expulsion, against me.
16. I shall not possess use or abet the use of any kind of weapons including sticks, rods, explosives, fireworks
or any such material and on being found guilty, the college may take disciplinary action(s), including
rustication/expulsion, against me.
17. I shall not keep excess cash & valuable with me & incase of any loss or damage of cash or valuables
including mobile phones, PC, laptop or any other personal belongings, the college shall not be responsible
for any kind of compensation. I shall be responsible to take care of my personal belongings in the college &
in case of any loss or damage to any such personal belongings the college shall not be responsible for any
kind of compensation.
18. I shall not collect any money from any student(s), employee(s), & any other person(s) for any purpose
including donations, contributions, gathering without the written approval of the college.
19. I shall not indulge in any political activities within the college & shall not commit myself or inside others to
any act political meeting, dharna, and strike satyagrah hooting etc weather violent or non-violent as the
same is prohibited by the law. I understand the necessary disciplinary action may be taken by the college&
that it may even lead to my expulsion /rustication from the college.
20. I further acknowledge that the students organizations have no legal right to interfere in the fundamental
rights of the management of the college to effectively run the college under article 19(1) (g) of the
Constitution of India.
21. I shall show due respect to all the teachers, officers of the college & hostel superintendents, all employees
of the college & the hostel. I shall show kindness & consideration to the new students admitted to the
college every year. I shall extend proper courtesy & decent behavior to all visitors of the college &
members of the family residing in the college campus, particularly to those of opposite sex. I shall not
indulge in any form of personal abuse, written or oral, directed against any student(s), resident(s),
guests(s), visitor(s) or member of staff/ faculty of the Mata Padmawati College of Nursing & their families,
particularly with respect to opposite sex. Engament in any of the above activities will be considered
grounds for serious disciplinary action.
22. I shall not indulge in any kind of immoral activities, willful damage or any or stealthy removal of any
property/belongings of the college/hostel, adoption of unfair means in the examination, irregular attendance
in class/laboratories/workshops, resorting to mass cuts of classes, test or examinations in any other
compulsory activity of the college; non-payment of college & other dues including mess & canteen
charges, any other act which may be notified by the college from time to time. Engagement in any of the
above activities will be considered grounds of serious disciplinary action.
23. The college has the full authority to call/send for official/academic purpose any time even during holidays
or for early or delayed stay even during night.
24. It shall be my responsibility to sign & submit the forms, affidavits, undertakings, information & other
document(s), as may be required by the college from time to time, & I understand that any unsigned
declaration(s) or affidavit(s) or undertaking(s) or indemnity bond or any other document(s) of the college,
which otherwise is required to be signed & attested by me or as prescribed by the university /college, either
declared or unintentionally, shall not relieve me of the obedience & /or compliance &/or implication of the
provision of such declaration(s) or affidavit(s) or undertaking(s) or indemnity bond or any other documents,
& /or submission to the disciplinary jurisdiction of the college. Such declaration(s) or affidavit(s) or
undertaking(s) as prescribed even if, undersigned by me for all matters concerned.
25. It shall be my responsibility to go through the eligibility criteria carefully & make sure of eligibility before
taking admission. I understand that my admission to the respective program/course, as applied for, shall
stand provisional unless conformed/approved by the university/college & shall also be subject to
cancellation as per the provisions. If on verification at a large stage, it is found incorrect or otherwise, the
candidature will be cancelled & shall be not be entitled to claim whatsoever against the college.
26. The college is entitled to make mandatory for me, as a student of the college to carry out the research,
training, industrial visits, seminars, study tours & other activities, in or outside the college, related to my
course of studies or otherwise & other co-curricular, extra-curricular& such other cultural, developmental
training & placement & other activities, & to charge the additional fees& charges for such activities besides
the transportation & other charges, as decided by the college.
 27. For any unforeseen issue arising, that is not covered by the undertaking, or in respect of all the matters, not
expressed provided, herein the college may take an appropriate decision that shall be final & bending on
me & all other concerned.
28. I have carefully read, with full understanding, the application form for admission for Regular program,
admission prospectus, admission guidelines & other related information & details& further it also shall be
my responsibility, to keep myself informed & update with the related information & the provisions given
in the college prospectus, admission booklet & /or otherwise; & to abide by the same.
29. I am giving this undertaking with full understanding & state that the information given by me above is true
& complete to the best of my acknowledge & believe & the certificates documents & the other information
submitted by me are genuine & nothing has been cancelled/ suppressed. I understand that my admission is
liable to be cancelled, on being found to be, ineligible or unfit for admission later on, or of using fraudulent
means for securing admission or otherwise, or if any of the statements made by me above are found
incorrect, & shall I be liable to such other disciplinary action(s), & /or penalty as may be decided by the
college, notwithstanding legal action under the law of the land. In such case, the fee deposited by me shall
also be forfeited.
30. It shall be my responsibility to submit the indemnity Bond on non-judicial paper to be signed by parents &
to be attested by the Notary Public/Executive/judicial Magistrate in the prescribed format of the college.
31. The college reserves the right to frame, amend, revoke or repeal the provisions & will be effective &
binding on all the concerned, as decided by the college from time to time.
32. The Courts in Sirmour District shall have the jurisdiction over all disputes arising out of or in respect of
mattersrelating to students including admission, academics, administration, residence, transport & all other
matters.

Acknowledgement

I have gone through carefully terms & conditions of the above undertaking & understand that following these are for
my own benefit & improvement. I also understand that, if I failed to comply with these terms&conditions will be
liable to suitable action as per the college rules & laws. I undertake that I will strictly follow above terms &
conditions.

Place ________________

Date ________________ Signature of the Student

Name of Witness I _____________ Name of Witness II _____________

Signature of Witness I ______________ Signature of Witness II ____________

 AFFIDAVIT BY THE STUDENTS

I, (full name of student with admission/registration/enrolment number Ms.

___________________________________________________________D/O ___________________________,
have been admitted in Mata Padmawati College of Nursing, have received & fully understood the Rules &
Regulations by the college as well as norms from the INDIAN NURSING COUNCIL, NEW DELHI &
HIMACHAL PRADESH NURSES REGISTRATION COUNCIL, SHIMLA.

1. I have, in particular, perused clause 3 of the Regulations & I am aware as to what constitutes ragging.
2. I have, in particular, perused clause 7 & clause 9 of the Regulations & I am fully aware of the panel &
administrative action that is liable to be taken against me in case I am found guilty of or abetting raging,
activities or passively, or being part of conspiracy to promote ragging.
3. I hereby solemnly aware & undertake that
a) I will not indulge in any behavior or act that may be construed as ragging under clause 3 of the
Regulations.
b) I will not participate in abet or propagate through any act of commission or omission that may be
construed as ragging under clause 3 of the Regulations.
4. I hereby affirm that, if found guilty of ragging, I am liable for punishment according to the clause 9.1 of
the Regulations, without to prejudice to any other criminal action that may be taken against me under any
panel law or any law under the time being in force.
5. I hereby declare that I have not been expelled or debarred from admission in any institution in the
country on account of being found guilty of, abetting or being part of a conspiracy to promote, ragging &
further affirm that, in case the declaration is found to be untrue, I am aware that my admission is liable to
be cancelled.
6. Participation in agitation, political activities, unhealthy propaganda or any such activity prejudicial to the
interest of the institute or otherwise is strictly prohibited & will attract disciplinary action.
7. I shall study at the college for the complete duration of the program opted for & due to any reason, I
leave/withdraw at any time before the completion of the program, I shall be liable to pay the fee for all
the successive terms & other pending dues (for the full academic year), if any.
8. I hereby affirm that, if I am not reporting for duty or refusing to do night duty or those work or, conduct
is not satisfactory will be liable to punishment even dismissal.
9. I shall not found in use of liquor or narcotics on Hospital duty or in institution premises, if I found guilty
of such an activity I shall be suspended from the institution for a specific period or expelled from the
institution.

Declared on this ______day of _____________month of _________ year.

___________________
Signature of deponent
Name of deponent

VERIFICATION

Verified that the content of this affidavit are true to the best of my knowledge & no part of the affidavit is false &
nothing has been cancelled or misstated therein. Verified at (place) on this the (day) of (month), (year).

Place_________________ ____________________
Name/Signature of deponent
Date__________________

Solemnly affirmed & signed in my presence on this (day) of (month), (year) after reading the contents of this
affidavit.
 Declaration

I hereby indemnify the University, against all rights & claims by myself, my dependents, next of other kin or other
legal representatives for damages or disability arising out of personal injury or death due to any reason, during the
course of my study(campus or of campus) in the University including during study, industrial visits, training, tours,
conduct of practical, working in laboratories or workshops, stay in hostel, travelling in transport or otherwise(within
or outside the precincts of the University).

Signature of Student

Place_________________

Date_________________

(To be countersigned by the Parent/Guardian)

(Signature of Parent/Guardian)

Name ______________________________________

Relationship with the Student ___________________

Date________________________________________
 AFFIDAVIT FOR FINANCIAL SUPPORT
ACADEMIC YEAR 2022-2025

I, __________________________________________ , the sponsor & financial

guarantor for Ms.
____________________________________________________, an applicant to
attend MATA PADMAWATI COLLEGE OF NURSING, NAHAN whose
relationship to me is _________________________________________________,
certify that I will support the person named above & that she will not become a
public charge during his/her stay in Nahan. I am aware the official estimate of the
annual cost for a GNM student attending the MATA PADMAWATI COLLEGE
OF NURSING, NAHAN is as follows & I am prepared to support the applicant in
the amount I have indicated below:

Rs. _______________ (GNM Course------ I Year)

Rs. _______________ (GNM Course------ II Year)
Rs. _______________ (GNM Course------ III Year)

I certify that all information provided on this affidavit & on the attached supported
documentation proving availability of funds in true & valid. I certify that I
understand this affidavit to be a biding document.

Name & Signature of Sponsor’s/guarantor _______________________________

Date_______________
(Month/Day/Year)
 AFFIDAVIT BY THE PARENTS
I _________________________father/mother/guardian of ___________________________
do hereby solemnly affirms & undertakes that:

1. My daughter/ward has submitted this application form for regular program with
full understanding & my express permission; & I shall hold myself responsible for her
good conduct & behavior as the student of the university & adherence to the provision of
the University.
2. I shall hold myself responsible for payment of all her fees & other charges as well
as during her stay University, pending dues, penalty etc.
3. I shall myself be responsible for any sort of liability arising out of any civil or
criminal case lying against my daughter/ward during the course of study in the
University.
4. I endorse the undertaking given by my daughter/ward.

Place ____________

Date _____________

(Full signature of the Parent/Guardian)

Name ______________________________________

Relationship with the Student ___________________

 UNDERTAKING FROM PARENTS

I acknowledge that I, _____________________________________________________

father/mother/guardian of _________________________________________, & I
understand that my daughter/ward, has submitted this undertaking as the same is
necessary for insuring proper & disciplined conduct of my daughter/ward. This
undertaking is also necessary to ensure that she will not indulge in ragging in any form &
other in disciplinary activities in the college premises including hostels.She willstrictly
follow the rules & regulations of the college, failing which I will abide by the action
taken by the college authorities or disciplinary committee against my ward.

Full name &signature of Parent with date

Phone No. (Including Mobile):_____________________Email:-

Address for correspondence:-

Name & address of local guardian with Phone No.: