2/18/25, 9:52 PM Registration Form

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Student Registration Form

Personal Information

Application No : 202481563 Global ID : 590019693

Course Registering for : BBA
Program Registering for : Finance Management
DOB (DD/MM/YYYY) : 09/07/2000
Name of the Student : Saurabh Yadav

Specially Abled : Yes No

Gender : Male Female Transgender

Email ID: [email protected] Mobile 8861787285

Alternate Email ID: [email protected] Emergency Mobile Number: 9216849837
Religion : Hinduism
Category OBC Caste Certificate : Click here to View

Blood Group A+ * PAN BGLPY0020L

Aadhaar Number 744410873054 Mobile linked with Aadhaar 8861787285

ABC/Apaar ID 206234325761 DEB ID 022501519453

Single Parent: Yes No

Father's Name : Rama Avadh Yadav Father's Contact No : 9839313380

Father's Income : 5,00,001/- to 10,00,000/-
Mother's Name : Mira Devi Mother's Contact No : 6307681784

Communication Information

Residential Address
Vill-Ajaon, Post-Chaubeypur, Dist- Vill-Ajaon, Post-Chaubeypur, Dist-
Building No. : Street :
Varanasi Varanasi
State : Uttar Pradesh City : Varanasi
PinCode : 221104
Correspondence Address
Vill-Ajaon, Post-Chaubeypur, Dist- Vill-Ajaon, Post-Chaubeypur, Dist-
Building No. : Street :
Varanasi Varanasi
State : Uttar Pradesh City : Varanasi
PinCode : 221104
Alternate number : 9216849837 Corres. Phone No : 8861787285

Academic Details

10th Percentage : 77.33 10th Board : UP Board

10th Year of Passing : 2016

12th Percentage : 56.80

12th Year of Passing : 2018
12th Board : UP Board

Uploaded Docs
Photograph Signature

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10th Marksheet 12th Marksheet

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Additional Details

Student Pan card : BGLPY0020L Student Aadhaar card : 744410873054

Payment Details
Total Course Fees Paid: 20000.00 Rupees Only.

UNDERTAKING CUM DECLARATION

Saurabh Yadav son/daughter of Mr. Rama Avadh Yadav have been selected for

BBA - (Finance Management) program in the University of Petroleum and Energy Studies, Dehradun for the Year 2024-2025

I affirm and undertake as follows:-

01. That I have acquainted myself with the rules of attendance (i.e. Minimum 75 %) and consequences of shortfall therein, and
undertake to abide by the same.

02. That I have not been involved in any criminal proceedings in the past and no criminal case is presently under investigation
by police or pending trial in any criminal court in India.

As an amplification of Cyber Laws / IT Policy of UPES, following acts of omission and commission by students is forbidden.
Implicit or explicit indulgence in such acts will constitute violation of / UPES IT Policy and Regulation 5 (c) xxiii of UPES
Regulations Governing Maintenance of Discipline Among Students wherein the following would be included as major acts of
indiscipline:-

03. That I shall not create any digital video recordings/ photographs of UPES community members either on campus or at off-
campus UPES events for online publication or distribution without their consent/ authorization.

04. That I shall not use social media sites to publish abusive, disparaging or harassing remarks about UPES students, staff, and
faculty members, athletic or academic contest rivals, etc.

05. That I shall not use social media for instigating, initiating, and furtherance of student unrest in forms of bunking of classes,
collecting students at a location, strike, demonstrations, and slogans against UPES.

06. That I shall not use inappropriate, abusive, loose and degrading language on social media forums.

07. That I shall not Post/upload teaching material – notes, power point presentations, copy of case studies, student advisory,
caution letter, penalty letter etc., Provided to me by faculty members / University on the internet without the authorization from
respective faculty members/ UPES authorities.

08. That I shall not start/create public pages, groups on social networking forums, that include Universities Name, and Logo
without the permission of UPES authorities.

09. That I shall not use the UPES name, logo, uniform, photos or other intellectual property (documents produced by the
University or students) when creating independent groups, Fan pages, or on one’s own site, without first obtaining permission
from the University.

10. That notwithstanding anything to the contrary contained in this undertaking cum declaration, I do hereby agree that in the
event of any information furnished by me at the time of registration or thereafter, found to be false and or misleading, my
admission to the University courses, shall be treated as invalid and cancelled, and thus void ab-initio.

11. That the results of the final qualifying examinations submitted by me, are not subject to any adverse remarks like retest,
failed in theory, subject yet to clear and or fail in a subject i.e., RT, FT, SYC, F etc.

12. That my admission shall be treated as provisional subject to my timely submission of pending documents, if any

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13. I have gone through, understood and shall abide by the rules, regulations and policies including the fee refund policy of
UPES.

While investigating the cases involving alleged or reported violation of cyber laws/ social media policy, or code of conduct of
UPES students, the UPES authority – The Registrar or her/his representative, and the School Proctors are empowered to
confiscate the communication device from the student, and examine it. Refusal on the part of the student to surrender his / her
communication device or altering its contents before surrendering it will be deemed to be a violation of code of conduct.

The University reserves the right to technologically investigate using Cyber Law Enforcement Agencies to find out Internet
Protocol (IP) addresses of such anonymous users

I have read and fully understood that in the event the contents of this Undertaking are found to be false or are
breached by me, whether fully or in part, I am liable to be removed from the Rolls of the University and the
decision of the University in this regard shall be final and binding on me.

Student Name : Saurabh Yadav

Contact No. (Student): 8861787285

Signature Student
Date :2/18/2025 9:50:21 PM (mm/dd/yyyy)

Disclaimer : I/We understand that if any of the above information is found to be incorrect or false, my/our ward shall be automatically debarred
from the selection / admission process without any correspondence in this regard. I/We accept the process of admission undertaken by the University
and I/we will abide by the decision taken by the University authorities. I have read all guidelines and information provided on the University website
and promise to abide by the rules formulated by the University. I also understand and agree that in all matters pertaining to admission, the decision
of the University authorities will be final and binding.

©2024 UPES. All Rights Reserved.

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