Shoolini Institute of Life Sciences and Business Management

(Affiliated to Himachal Pradesh University, Shimla)

Anand Campus, The Mall, Solan 173212 (H.P) Tel. 01792 226674

Admission Cum Registration Form

(for details please consult prospectus) No Column Should Be Left Blank

Affix your duly

attested latest
colour passport
size photograph

Admission form No:

Enrollment No:
(To be filled by office)

Category:

Gen

SC

ST

Others

(Attested photocopy to be attached in case of SC/ST)

Course applied for _____________________________________________________________

HP CMAT Score (For MBA Only):

or MAT Score (For MBA Only):

State of Domicile:

HP

Other

State from where you passed the qualifying examination:

HP

Other

1. Name of the Candidate (In block letters) _____________________________________________

2. Fathers Name (In block letters) ____________________________________________________
3. Mothers Name (In block letters) ___________________________________________________
4. Date of birth (In figures)_________________________________________________________
(In words)____________________________________________________________________

5. Gender: Male / Female_________________________________________________________

6. Permanent Address ___________________________________________________________
__________________________________________________________________________
_______________________________________________ PIN _______________________
7. Address for correspondence ________________________________________________ ____
_______________________________________________PIN_______________________
8. Telephone No. of Parents /Guardian_______________________________________________
9. E-mail ID of Parents /Guardian________________________________________________
10. (a) Academic Qualification (10th onwards) (Attested photocopies to be attached in support)
Examination University/Board

Year

Subjects*

Marks
Obtained

Maximum
Marks

Result with
Percentage

* Subjects column to be left blank if applying for MBA

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(b) Whether disqualified from any examination

YES

NO

Give details (in case of yes): ____________________________________________________________

____________________________________________________________________________

c) Is there any criminal case pending against you

YES

NO

Give details (in case of yes):________________________________________________________________

_____________________________________________________________________________

11. List of documents attached

a) ___________________________

e) ___________________________

b) ___________________________

f) ___________________________

c) ___________________________

g) ___________________________

d) ____________________________

h) ___________________________

Note: Candidates are required to attach the attested photocopies of the following documents
(originals are required for the verification at the time of the admission. Attestation should be
done by the Gazetted Officer / Notary Public / Bank Manager / Magistrate)
1. Certificate & detailed mark sheet of the qualifying examination, other academic
certificates.
2. Certificates from the competent authority, in case of SC / ST / others.
3. Character Certificate from the school / institute last attended.
4. Certificates pertaining to extracurricular activities (sports, cultural activities etc).
5. Three passport size photographs.
UNDERTAKING FOR NOT INDULGING IN RAGGING
(a) From student
I, -----------------------------------son/daughter of-------------------------------------------of class-------------------------------do hereby declare that I am fully aware of the institutes
approach, Supreme court directive & H.P. Government Ordinance towards ragging and the
punishments to which I will be liable if found guilty of ragging.
Signature of student:
Name of student:
Date:
(b) From parents / guardians of the applicant.
I, ---------------------father / mother / guardian of -------------------------------------------------do hereby declare that I am aware of the institutes approach, Supreme court
directive & H.P. Government Ordinance towards ragging and the punishments to which my
son /daughter,-----------------------------------, will be liable if found guilty of ragging.
Signature of parents / guardian:
Name of parent /guardian:
Date:
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DECLARATION
I shall abide by the rules and regulations of the Institute and shall not indulge in any unlawful
and undesirable activities
Date _____________
Place _____________

Signature of the candidate

Countersigned
(Parent/Guardian)

Hostel Accommodation

Required

Not Required

Signature of the candidate

Countersigned
(Parent/Guardian)

(FOR OFFICE USE ONLY)

Certified that the candidate has attached all the documents enlisted above. He/She is eligible/not
eligible for admission as per H.P. University Ordinance.

Admission Cell

Recommendation for Admission

Admitted

Dean / Director (Seal)

President (Seal)

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