Indian Institute of Science Education and Research Kolkata

Application no:
213382
APPLICATIONFORM
Integrated PhD Programme (Autumn 2014)
Your Application Number is 213382. Please quote this number in any further communications.
Please take a printout of this document and bring it along with you.
Name: Shibashis Paul
Date of Birth: 23-11-1993
Gender: Male
Marital Status: Single
Category: General
Nationality: Indian
Blood Group: B+
Distinguishing Mark: NA
Permanent Address: 7/131 MUKUNDAPUR, KOLKATA,WEST BENGAL
KOLKATA - 700099
West Bengal, India
Fathers name: Shib Sankar Paul
Guardians Name: Shib Sankar Paul
Emergency Phone Number: 09831756011
Cell Phone Number: 07278651426
Email: shibashispaul32@gmail.com
0 213382 7
Educational Qualications:
Name of Examination Board/University Name of Institution Year of Passing Percentage
10th WBBSE PANCHASYAR SIKSHA
NIKETAN
2009 75.4
12th WBCHSE PANCHASYAR SIKSHA
NIKETAN
2011 82.7
BSc UNIVERSITY OF CAL-
CUTTA
SCOTTISH CHURCH COL-
LEGE
2014 79.8
Applying For:
Position: Integrated PhD in Chemical Sciences (Autumn 2014)
Qualifying Examination:
(1) JAM (2014), Rank: 143, Percentile: 62.33;
I, Shibashis Paul, hereby declare that all the particulars furnished above are correct to the best of my knowledge and any change in the above information
in future will be immediately intimated to the Institute. I understand that if at any point of time, any of the information is found to be false, my application may
be cancelled and the Institute may take any necessary action against me.
Date: May 18, 2014
(Signature of Candidate)
SHIBASHIS PAUL