Application for Admission to Pre-University Course | 2025-26

I, Mr./MsFull Name* s/o or d/o or w/o Full Name* student of Program   Course Name*   Visthar Academy of Culture and Contemporary Studies, permanent resident of   Street Address*   Address Line 2*   City*   State*   Zip*    Country Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno-Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Turkish Republic of Northern Cyprus Northern Mariana Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Republic of the Congo Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia South Sudan Spain Sri Lanka Sudan Suriname Svalbard eSwatini Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Transnistria Pridnestrovie Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands Isle of Man US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe *   Phone Number   Area Code*   Phone Number*   (Give permanent home address with telephone no.), do hereby undertake this the   Date*   as under;-

1. I hereby declare that the entries made by me in the Application Form are complete and true to the best of my knowledge, belief and information.
2. I hereby undertake to present the original documents for verification immediately upon demand by the concerned authorities of the Institute.
3. I hereby promise to abide by the rules and regulations concerning admission, attendance, discipline etc. of VA and follow the Code of Conduct prescribed for the Students of VA as in force from time to time and subsequent changes/modifications/amendments made thereto. I acknowledge that the VA has the authority for taking punitive actions against me for violation or non-compliance of the same.
4. I understand that 75% attendance in classes is compulsory and I commit myself to adhere to the same. I also understand, that in case my attendance falls short, for any reason, the competent authority of the VA may take such punitive action against me, as may be deemed fit and proper.
5. I hereby declare that I will neither join in any agitation/strike for the purpose of forcing the authorities of the Institute to resolve any problem, nor I will participate in any activity which has a tendency to disturb the peace and tranquillity of the academic environment of the VA campus and/or its Hostel premises.
6. I hereby declare that I will not indulge in nor tolerate ragging in any form, even in words or intentions, and I accept to give an undertaking in the prescribed format for the same.
7. I hereby declare that I shall be solely responsible for my involvement in any kind of unlawful activities whether inside or outside the campus and shall be liable for punishment as per the law of the land. I further understand that the Academy shall in no way provide any support to me and will not be held responsible for my any such action.
8. I hereby acknowledge that I shall be liable for expulsion forthwith from the VA on being found involved in or committing any offence cognizable and punishable under the Narcotic Drugs and Psychotropic Substances Act, 1985.
9. I further declare that my admission may be cancelled, at any stage, if I am found ineligible and/or the information provided by me is found to be incorrect.
10. I hereby undertake to inform the VA about any changes in the information submitted by me in the Application Form and any other documents, including changes in addresses and phone nos., from time to time.
11. I will strictly adhere to the code of conduct as laid down by the Student’s Conduct and Discipline Rules 2019 and Hostel Rules and Regulations 2019 and will not indulge in any act of indiscipline while inside or outside the VA campus.