UNDERTAKING / AGREEMENT [1](TobefilledbythecandidateonJudicialBondof Rs.30/-anddulyattestedbytheDeputyCommissioner/

PoliticalAgent/DCO/FirstClassMagistrate).

IMr./Miss. ___________________________ Son/Daughter/Wifeof __________________________ Resident of _______________________________________________________________________ __________________________________________________________________________________Do hereby solemnlyundertaketoabidebythefollowing:

i. ThatIhavereadtheProspectusof KIDS andherebyagreetoconformtoallprovisionsof therules and thestatutes/rulesasmayhereafterbeframedbythe appropriateauthorities.

ii. Thattheinformationfurnishedin,anddocumentsattachedwiththeapplicationform,are correct,andIfullyunderstandthatat anytimeduringthecourseofmystudy,if itisfound thatanyinformationis in-correctoranydocumentproducedat thetimeof admissionis false,whichwouldhaverenderedmeineligibleforadmissionundertherules,myname shallimmediatelybestruckoff theinstituteroll.

iii. ThatIshall,in casemynameisstruckoffunderclause(ii)above,notbeentitledtoclaim refundof anyfeepaidbyme.In additionIshallpayto thePrincipalasliquidateddamages attherateof Rs.100,000(oneLac)peryearofmystudiesin KIDS.

iv. ThatIshall,haveminimumattendanceof 75percent,diligentlyapplymyselftoacquireand developtheskillnecessaryforthepracticeandadvancementof mystudyin orderto qualifyforexaminationandI willnotbepromotedtothenexthigherclassunlessIhave clearedallthesubjects.

v. ThatIshallmaintainidentityasastudentof the institutebywearingInstituteuniform.Ishall participatefullyandwholeheartedlyingamesandextracurricularactivities.

vi. Thathostelaccommodationwillbeprovidedsubjecttoavailability,incaseof non- availabilityof hostelaccommodation,Iwillnotaskforanyaccommodation.

vii. ThatIwillnot indulgeinpoliticsof anytypeandwillnotbeamemberof anypoliticalparty/organization/studentsFederation,holdinga gathering,meetingortakingoutprocession in anypartof Campus.Iunderstandthatmyfailureto observethisclauseof undertaking wouldresultincancellationof myadmission/expulsionfromtheInstitute,andthatthe decisionof theauthoritiesconcernedwillbefinal.

viii. ThatIshallneveruseviolence,threatof violenceandpressurein anydisputewithothers, allmeansandmethodsshallonlybelogic,persuasion,petition,appeal,revision,review andotherlegalandpeacefulmethodforsettlementof differencesanddisputes.

ix. Thatinanydisputewithstudents,teachersandemployeesof theinstituteI shallacceptthe judgmentof thecommitteeconstitutedbythe principalfordecisionof settlementof the wrongdoers.

x. Further,Idoherebysolemnlyundertaketorefrainfrom:-l. Doinganythingwhichmaycauseinjuryorinsultto head,teacher,officersandotherstaff of

institution.m. Holdinga gathering,meetingandtakingoutprocessioninanypartof Campusotherthan

areasspecifiedforthepurpose.n. Allkindsof unfairmeansin examination.o. Allowingorabettingtheentryto thepremisesof the Instituteof expelledstudents,anti-

socialelementsorotherswhosepresenceintheCampuscouldcauseconflictamongstthe students.

p. BringingintotheCampus,consumingor encouragingconsumptionof alcoholicproducts, drugsandnarcoticsandindulginginactsof moralturpitude.

q. Bringingorkeepinganytypeof weaponswithintheUniversity/ Institutepremises.r. Usingoroccupyinganyroomorpartof anybuildingof theInstitutionwithoutlawful

authority.s. Sublettinganyhostelroomtounauthorizedpersons.t. DamaginganyUniversity/Institutepropertyincludingbuilding,equipmentand

vehiclesetc. in anymanner.u. Indulgingin anyviolentoranyotherunsuitableactivitiesevenoutsidethe Institute,which

maybringbadnametotheInstitute.v. Fromallsuchactsanddeedsas mightbringdisgraceandbadnametotheInstitute.

xi. IncaseI am reportedto beguilty/ involvedin anyof theaforesaidactivitiesduringmy stayinthemedicalInstitute,theInstituteauthoritiescanrusticatemefromthe Institute temporarilyorexpelmepermanently.I willnottrytocreatelawandordersituationor instigatethestudentsof theInstituteorof anyotherinstitutionagainsttheactiontakenby theinstituteandfurthermoreIwillnotgoto anyCourtof Lawin thisregard.In caseof my expulsionfrom InstituteI shallpaytothePrincipalasliquidateddamagesat therateof Rs.100,000(oneLac)peryearofmystudyintheInstitute.

xii. If itisreportedthatI havenothonoredthedecisionof the Instituteauthoritiesas describedabove,I shallbeliableto payRs.2,00,000/-(TwoLac)per yearofmystudyin theInstituteasdamagesto theKhyber Medical University

xiii. Incasethereisanydisputebetweenmeononehandandtheadministrationof the Instituteontheotherhandregardingmyinvolvementin adisciplinaryorpolitical matterorregardingtheimpositionof anypenaltyordamagesonme,themattershallbe referredtothePrincipal,asthesolearbitratorandhis decisioninsuchcapacityshallbe finalandshallnotbechallengedin anycourtof law.

xiv. Iwillabidebythedecisionof theInstituteAuthorities.IncaseIamfoundguiltyof indiscipline,defamation,disrespectof theStaffandotheranti-institutionalactivities,I will abidebytherulesanddecisionsregardingthehousejob.

xv. Iunderstandthatif it is foundthatI wasnotentitledforadmissionaccordingtotheKIDSAdmissionpolicyatanystageof BDScourseor if it isfoundthatI wasnot entitledfor admissionin preferencetotheothercandidateswhoappliedforadmission,myadmission willstandcanceled.

xvi. IsolemnlydeclarethatIdo nothavedoubledomicilecertificate.

Signature of the Student: _______________________________________Name: _______________________________________CNIC No / Computerized Form – B No: _______________________________________Father’s Name: ________________________________________CNIC No: ________________________________________Permanent Address: ________________________________________________Present Postal Address: ________________________________________________Dated: ______________/________________/__________________

TocontinuefromnextpageUNDERTAKING / AGREEMENT [2]

Tobefilledbyfather/mother/husband/guardianof thecandidateonJudicialBondof Rs.30/- andduly attestedbytheDeputyCommissionerPoliticalAgent/DCO/FirstClassMagistrate).

I _______________________________ Son/Daughter/Wifeof ___________________________ andFather/Mother/Husband/Guardianof ____________________________________ herebyfullyendorsetheundertakinggivenbymySon/Daughter/Wife/Wardandassurethathe

/shewillabidebythisundertakingduringhis/herstayin theInstitute.iii. IalsomakemyselfliabletopayRs.1,00,000(onehundredthousand) peryearof his/ herstudyin

theInstituteincaseof anybreachof theabovementionedundertakingbymy Son/Daughter/Wife/Ward,Mr./Miss._________________________________________.

iv. I _____________________ Father/Mother/Husband/Guardian of Mr./Miss ______________________ assurethatmySon/Daughter/Wife/Wardwillnot indulgeinpoliticsof anytypeandwillnotbe amemberof anypoliticalparty/organization/studentsFederationnorwillhe/ sheattendanymeetingof suchorganizations.Such involvementonhis/herpartmayleadtohis/her expulsionfrom the Institute,andthatthe decisionof the Principalin thisregardwillbefinal.

DEPONENT

Signature: ___________________________Full Name: ___________________________CNIC No: ____________________________Father’s Name: _______________________PresentPostalAddress: ____________________________________________________

Witness-1 Witness-2Signature: ______________________________ Signature: __________________________________Name: ________________________________ Name: ____________________________________CNICNo: _____________________________ CNICNo: _________________________________Father’sName: _________________________ Father’sName:______________________________Present/PostalAddress: _________________ Present/PostalAddress: ______________________________________________________________ _____________________________________________Permanent PostalAddress: ________________ Permanent Address: _________________________________________________________________ _____________________________________________

ATTESTEDSignatureand Stampof PoliticalAgent/FirstClassMagistrate

AFFIDAVIT FOR GUARDIANSHIP(Tobefilledonstamppaperof anydenomination) (TO BEPRODUCEDONSTAMPPAPER)

I ___________________________________ Son/Daughter/Wifeof

____________________________ do hereby solemnly declare that my father has died in the year

________________________ and ________________________________ is myguardian.

3. Signatureof candidate: _________________________________________

Nameof Candidate: _________________________________________

CNICNo.of candidate: _________________________________________

4. Signatureof Guardian: _________________________________________

Nameof Guardian: _________________________________________

CNICNo.of Guardian: _________________________________________

CERTIFICATE OF LOCATION OF EDUCATIONAL INSTITUTES(TobesubmittedbythecandidatesapplyingagainstBackwardAreasandFATAinnerseats)

OfficeofExecutiveDistrictOfficer(Education)District/Agency/FR:_______________________

Certified that Mr./Ms. ___________________________ S/O,D/O __________________________

has beenstudyingintheDistrict/Agency/FRof ________________________ as follows:

Class FullNameof School/College Year(From-

Board

Primary(1-5)

Middle(6-8)

Matric(9-10)

F.ScPart-I(11)

F.ScPart-II(12)

Signature of EDO (Education)With official stamp

Verified by the DCO of concerned District/FR or PA of Agency

DCO/PA: __________________________________With official stamp

STUDY COMPLETION BONDTobefilledbythe studentonStamppaperof Rs.30/-anddulyattestedbyFirstClassMagistrate/Political

Agent/OathCommissionerinthepresenceof twowitnesses.

I___________________________ S/O/D/O/W of ________________________________ hereby

solemnlyaffirmsthatIwillcompletethewholetenureof mystudyof fiveyearsBDSPrograminKIDS.

Iwillnotseekadmissionin anyothermedicalinstitutenorwill Ireappearin ETEAtestatanystageof mystudy

tenure.

Ifurtheragreetotheprovisionthatmyoriginaldocumentsshallremainin safecustodywithKIMStillthe

completionofmystudytenureandIshallnotdemandforitsreturnbacktomebeforethecompletionof my

studytenure.Incase,Iintendtocancelmyadmissionat anystageofmystudyperiod,aftertheclosureof admission,Ishall beliableto a penaltyof Rs.400,000/-(FourHundredThousand)forwastinga preciousseat.Theoriginal documentwillbereturnedtomeonlyafterthepaymentof theduepenalty.

Signatureof Student: _________________________________________________________

Nameof Student: _________________________________________________________

Father'sNameof thestudent: ______________________________________CNIC#ofthestudent: _____________________________________PresentPostalAddress: _______________________________________________________________________________________________________________________________________PermanentAddress:

____________________________________________________________________________________________________________________________________________Witness-1 Witness-2Signature: ______________________________ Signature: __________________________________Name: ________________________________ Name: ____________________________________CNICNo: _____________________________ CNICNo: _________________________________Father’sName: _________________________ Father’sName:______________________________Present/PostalAddress: _________________ Present/PostalAddress: _____________________________________________________________ _____________________________________________Permanent PostalAddress: _______________ Permanent Address: _________________________________________________________________ _____________________________________________

Signatureand StampofFirstClassMagistrate/PoliticalAgent/OathCommissioner:

_____________________________________