Undertaking - C4YWebApp

Personal Details

First Name *

Middle Name

Surname / Last Name *

Gender *
Male Female

Nationality *

State *

City *

Mobile Number *

Student's email ID *

Parent/Guardian Details

Parent / Guardian Name *

Parent / Guardian Phone Number*

Parent / Guardian Address *

Parent / Guardian Email *

Parent / Guardian City *

Parent / Guardian State *

College Details

Educational Institute Type * **Affiliated College:- Colleges that are affiliated with any university. (Any Regular college)
**Standalone Institute:- Institutes which are not dependent on any university. (Teacher Training, Nursing etc)
**University:-Univeristies that provide courses without any colleges. (Same as Regular Courses without any colleges.)

State in which college is based *

Name of the College *

College Name

College Code

Name of Affiliated University

University Code

Director's Name *

College Phone Number *

College Landline Number

Nearest Police Station *

Course Details

Under Graduate or Post Graduate *

Name of the Course *

Number of Students in your Class *

Current Year of Study *

UGC Regulations

I confirm that I have read UGC's regulations on Ragging.(To read, click on the link ABSTRACT OF UGC REGULATIONS ON RAGGING)

I confirm that I have read the Judgment of the Hon. Supreme Court on prevention of Ragging.(To read, click on the link SUMMARY OF THE JUDGMENT OF THE HON. SUPREME COURT )

I promise that I will not indulge in Ragging or any form of violent behaviour. Neither will I tolerate being ragged or subjected to violence.

I understand that if I am accused of Ragging, the responsibility is on me to prove that I am not guilty.

I will not remain a spectator to acts of Ragging. I will report the matter immediately to my Principal/Director and/or to the Anti Ragging Help line at 1800 180 5522 or email to info@antiragging.in

Confidential Survey

Please answer these questions truthfully and honestly because this survey is totally Confidential, So no part of this survey is going to show anything to your college. Your college will only know that you have participated in this survey

Were you ever ragged ? *
No Yes

Did you ever rag anybody ? *
No Yes

What is the phone number of National Anti Ragging Help Line *

Does ragging happen in your college ? *
No Mild Severe

WARNING: Please Recheck Your Details (speacially Email addresses and Mobile) Before Submitting the form I have rechecked the form and confirm that all the details are correct.