DECLARATION
I declare that the particulars furnished in this form are true to the best of my knowledge and belief. I further
declare that in case any of the above information is found to be incorrect at any time, I shall be liable to
forfeit my seat and to such penal action as the college authority may deem appropriate.
Date: Full signature of the Applicant
List of enclosures required:
1. Three recent color passport size self attested photographs.
2. Self attested copies of mark sheets and certificates of all the examinations passed (from HSC to PG).
3. Self attested copy of conduct certificate from the institution last attended.
4. Certificate of SC/ST, if applicable.
5. College leaving certificate in Original.
6. Two Self-Addressed Envelopes (22cmx10cm)
7. Self attested copy of Registration Certificate of Utkal University of Culture, if already registered.
8. Migration Certificate in original (students from other university)
9. Money /Phone Pay Receipt of Rs.25500/- in original towards purchase of form and admission fees.
PAYMENT DETAILS
* All payments are to be made (Not by Cash) to ‘Sivananda Yoga Vedanta Academy bearing SBD
Account No. 09230103148572,UCO Bank, Main Branch, Bapuji Nagar,BHubaneswar, IFSC:
UCBA0000470),BHUBANESWAR.
