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APPLICATION FOR ADMISSION TO THE B.A./B.SC./B.COM (HONS./GEN.) COURSES FOR  1ST SEMESTER SESSION : 2018 – 2019


FOR OFFICE USE
Date of Admission : Course :
Class                       : Subject :
Student’s Id             :
Roll No.:                  :

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Signature Signature

 

 

 

 

 

Application Id :

Application Date :

Print Date : 19/12/2018 04:45:26 AM

 

PERSONAL PART

1.   Name (in Block Letters) : 2.   Date of Brith :
3.a).Permanent Address with Pin Code :
   b). Police Station ( P.S.) :
4.   Contact No. :
5.    Present Address with Pin Code :
6.   Guardian Phone No : 7.   Nationality :
8.   Religion : 9.   Minority :
10.   Gender : 11.   Caste / Category :
12.   Sub Caste : 13.   Physically Handicapped :
14.   Father's Name : 15.   Father's Qualification :
16.   Mother's Name : 17.   Mother's Qulification :
18.   Guardian's Name : 19.   Guardian's Occupation      :
20.   Annual Income : 21.   Annual Income Category :  
22.   Relation with Guardian : 23.   Marital Status :  
24.   Co-Curricular prog intended to be taken up :
 

ACADEMIC PART

25.   H.S.Roll No./Index No. : 26.   Year of Passing :
27.   Name of H.S Passing Board :
28.   Name of H.S Passing School :

29.  Statement of marks obtained in the H.S./Equivalent Examination

Subject

Full Marks

Theory

 

Theory

 

Theory

 

Theory

 

Marks Obtained

APPLICATION PART

30. Subjects Applied for :


Declaration by the Candidate :I do hereby declare that the above particulars are true to the best of my knowledge and belief and no relevant information are suppressed or omitted. I promise to abide by the rules and regulations of the College.



Date  :

 

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Signature of Candidate

Declaration by the Father/Guardian :I do hereby certify that the applicant has taken my permission to seek admission in Basirhat College and  the statements made therein are to the best of my knowledge and belief.


Date  :

 

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Signature of Father/Guardian


FOR OFFICE USE                  Admit

                              
                                   Principal/ Teacher-in-Charge
                                                Verified 

                                             
                                                 Signature