Ansal University

International Students Application form

Online Application Form

1. Program of Study:

Program* :
Course* :
Semester:
(for Lateral entry only)

2. Personal Information:

Name of Applicant

First name*

Last name*

Family name

Date of Birth* :
Gender*:

Upload Passport Size Photo

(Size of photo: 2 x 2 inch, 35 x 45 mm or 35 x 35 mm (5 x 5 cm, 3.5 x 4.5 cm, 3.5 x 3.5 cm). Color of background: white or off-white)

3. Address:

Permanent Address* :
Province* :
City* :
Postal code* :
Country* :
Local Address (if applicable):
Province:
City:
Postal code:
Country:

Email Address* : (An email address is mandatory so we can send your correspondence)

Mobile:
Country code* :
Number* :
Landline:
Country code:
Number:

4. Citizenship Details:

Country of Birth* :
Passport Details
Country Issued* :
Passport no* :
Place of Issue* :
Date of Issue* :
Expiry Date* :
Visa (if Applicable)
Country Issued:
Visa No:
Date of Issue:
Date of Expiry:
Issued at:
POI/OCI card (if Applicable)
Country Issued:
POI/OCI no:
Date of Issue:
Date of Expiry:
Issued at:

Please Upload Passport

Parent / Guardian / Spouse Information: (Will be contacted at the time of Emergency)

Name*
Relationship*
Address*
Phone no*
Email*

5. Educational Details:

Certificate / Degree*
Institution / Place*
Course / Specialization*
Grade / Score*
Year*
StartFinish
Completed *
YesNo
1. High School *

High School Certification

2.Higher Secondary *

Higher Secondary Certification

3. Graduate

Graduate Certification

4. Masters

Masters Certification

6. What Program are you applying for: (Provide drop box)

Course / Program*

7. Category:*

8. Funding your Studies:

01
Are you aware of the living costs associated with your studies in India?
/
02
Do you have access to sufficient funds to support your TOTAL period of your stay in India?
/
03
Are you aware of and have you read the Ansal University fee refund policy?
/
04
Are you aware of the work restrictions while studying full-time in India?
/

Who will be paying for your studies and living expenses while in India?

Do you have relatives in India?

/

If yes, please provide:

9. English Language Proficiency:

What is you first language* :
Have you ever had your English language abilities or proficiency tested?
/

What level was your English language assessed at? (Please attach a verified copy of your results)

TOFEL

Score

Computer Based

Paper Based

IELTS:

Reading
Listening
Writing
Speaking
Overall score
Others
If you have not sat an English proficiency test in the last 3-4 months, do you want to enroll at Ansal University language course?
/

Upload for IELTS / TOEFL certificate

10. Statistical information:

How do you hear about Ansal University? Please tick one

Others please mention

11. Impairments:

Do you live with the effects of a significant injury, long-term illness, or disability?
/

If yes, please indicate by ticking the appropriate box below

Others - please state

12. Criminal convictions

Have you ever been arrested/prosecuted/ convicted by any court of law?
/
If Yes, please provide details:

13. Information:

Have you ever been dismissed from a college for disciplinary reasons?
/

14. Declaration of student:

I certify that the information on this application is correct. False information or omission of data may result in denial of admission or dismissal. I will make myself familiar and comply with provisions of Ansal University Policies and Regulations obtainable from the University website, www.ansaluniversity.edu.in.

  1. I declare that all information provided with this application form is correct and that I/we have read and understand and agree to be bound by the Terms and Conditions relating to this application.
  2. I agree that in the event that false, inaccurate or misleading information is provided, Ansal University reserves the right to cancel the enrolment.
  3. I agree to pay the applicable tuition fees set out on www.ansaluniversity.edu.in.in prior to the commencement and subsequent semesters of the nominated studies. Additionally, I/we agree to be jointly or severally liable to the debt arising from fees owing.
  4. I agree that when I am accepted for enrolment in Ansal university, I must comply with and ensure that the student complies with the terms and conditions of enrolment and Ansal University Student Handbook and Student Code of Conduct.
  5. I understand and consent that personal information provided by the student to Ansal University may be made available to the health insurance provider, to State agencies and or contractors, engaged by Ansal University to provide advice or services in connection with any aspect of Ansal University’s international students program or operation.
  6. I hereby consent to being contacted by Ansal University by text message, email or other electronic means and note that I/we may, at any time, opt out of being contacted by any such electronic means by contacting Ansal University and so advising.

15. Application Checklist:

Answered ALL questions?

Select "I accept" to confirm that you have read and fully understand the terms and conditions set forth in our Application Policy.