Programme Subject Name of Student* D.O.B (DD/MM/YYYY)* Gender MFTG Category GeneralOBCSCSTOther Father’s Name Mother’s Name Permanent Address Correspondence Address Online Registration Status RegisteredNot Registered State of Domicile Nationality Aadhaar Number Contact Number(Mob.)* Email ID* Details of Examination PassedAppeared Examination Year of Passing School/College Name of Board/University Max. Marks Marks Obtained % of Marks Subjects 10th 12th Under Graduation Post Graduation Details of Entrance Examination (If Applicable) Test Year Score Rank Self Attested Marksheets Candidate Photograph Reference Person Name Reference Contact Number Source/Ref(FB/Instagram/LinkedIn/Other's) Enrollment Fee Rs.500/-; Registration Fee Rs.1000/-; Tuition Fee (Per Semester Fee) Rs Mode of Payment: Transaction ID: Screeshot of the payment Total Amount of Tranaction: Please deposit fees in favor of Bank Details:Himalayiya University Punjab National Bank Branch Raiwala, Dehradun, Uttarakhand A/C No.: 0922002100102159 IFSC: PUNB0092200 UNDERTAKING: I solemnly affirm that the information furnished above is true and correct in all respect. I have not concealed any information. I undertake that if any information finished herein is found to be incorrect or untrue, I shall be liable to criminal prosecution and also forgo my claim to admission to the University. Further, my candidature for the admission to the course shall be liable for cancellation at any stage. I agree to abide by the rules and regulation of the University.