Rawalpindi – Admission form

STUDENT ADMISSION FORM

FORM SA-001

Note: To be filled in by the candidate prior to admission. Please attach passport size photograph, a copy of your CNIC, a copy of father’s CNIC, copies of academic certificates and personal statement.

abc

Date of Admission

Form No.:

Full Name

PHOTO

Father/Guardian Name:

Mother Name:

CNIC #:

Profession:

Contact #:

Applicant CNIC No.:

Date of Birth:

CNIC EXPIRY:

Gender:

Male Female

Nationality:

Pakistani Other:

Age of Student at the time of filling this form:

Year

Months

Postal Address:

Postal Address line 02

Home Telephone:

Mobile No:

E-mail Address:

Qualification / Degree Title	Awarding Institution	Year of Graduation	Grade / Result	Copy Attached
				Y N
				Y N
				Y N

Copy attached 01

Copy attached 02

Copy attached 03

N/A

Food and dietary requirement:

Allergies or major illnesses:

Any disabilities:

Blood Group:

Name:

Address:

Phone #:

Relationship to Applicant:

Programme

IVY School / Department applied to:

Level of Qualification applied for:

Institute / University:

Name of Qualification:

Undertaking

I hereby declare that:

The information provided on the Student Admission Form (SA-001) is, to the best of my knowledge and belief, true and correct at the time of filling this form.
I understand that my final exit award/official transcript will bear the same particulars as they appear on the form and IVY is not responsible for any amendment claims after the award of degree/transcript, unless the management is informed in writing of such changes with evidence otherwise.
I understand that in order to achieve relevant years of education equivalence from Higher Education Commission Pakistan, it is essential to have attained IBCC equivalence prior to admission in IVY.
I agree to Roots IVY International College processing my personal data contained in this form and other personal data that the college may obtain from time to time for academic references, partnerships, administrative support and joint educational programmes with organizations and people external to RIIC. The information may be shared for student promotions, benefits and discounts. Furthermore, I agree to the retention and disclosure of such data in accordance with the Policies of IVY.
A fee refund from IVY College will only be granted if an offer letter from the partner university is not received.

I CERTIFY THAT I HAVE READ, UNDERSTOOD & AGREED TO THE IVY Policies,
including but not limited to, fee refunds and campus relocation

Student Signature:

Parent’s / Guardian Full Name:

Student Full Name:

Department:

Branch Address:

Date

Parent / Guardian Signature:

Please note that the IVY rules, regulations, requirements, policies, and standard terms & conditions may be periodically revised without prior notice.

Head Office: Plot No. 20, Street Near Eiffel Tower, Overseas 1 Commercial, Phase VIII, Bahria Town, Phase 7, Rawalpindi - 46000 - Pakistan

STUDENT ADMISSION FORM

FORM SA-001

Programme

Undertaking

Select Signature Option

Select Parent / Guardian Signature Option

STUDENT ADMISSION FORM

FORM SA-001

Personal Information Personal Information

Terminal Qualifications Terminal Qualifications

Please provide health and security information Please provide health and security information

In case of an emergency, IVY may contact: In case of an emergency, IVY may contact:

Programme

IVY School / Department applied to: IVY School / Department applied to:

Level of Qualification applied for: Level of Qualification applied for:

Details of Qualification applying for: Details of Qualification applying for:

Undertaking

Student Undertaking Student Undertaking

Draw Your Signature

Select Signature Option

Parent / Guardian Undertaking Parent / Guardian Undertaking

Draw Parent / Guardian Signature

Select Parent / Guardian Signature Option