West Bengal University of Technology Application form for Registration

(B. Tech.-B. Pharm.-B. Arch.)

BGBL
(Application ID)

The Registrar, West Bengal University of Technology BF-142, Saltlake, Sector-1 Kolkata-700064, West Bengal
Sir, I hereby apply for registration as a student of West Bengal University of Technology. A sum of Rs. 400/- is remitted herewith as Registration Fee for the academic session 2012-2013. Necessary particulars relating to myself, given below, are true to the best of my knowledge. Place:_______________ Date: _______________ Signature of Applicant (Please Sign within the box)

Affix recent passport size photograph

Registration applied for : Lateral Entry Roll No. (if Re-Admission / Branch Change): Registration No. (if Re-Admission / Branch Change): Session Year : 2012-2013 Degree : B. Tech. Registration Against : JELETE Enrollment No: 891020169

(LCS)

Name : Smritikana Ghosh Rank & Category : (JELETE), 5001, ETC (GEN) College Name : JIS College of Engineering Course : B.Tech. in Electronics & Communication Engineering Applying for concession : NA

Sex: FEMALE Category: GEN Physically Challenged: N Nationality : Indian Religion : Hindu Father's Name : Ramprosad Ghosh Mother's Name : Ranu Ghosh Address : LAXMIPURMATH,KANTAPUKUR,P.O.+DIST.-BURDWAN PIN-713101 Phone: 9474178047 Email: ramprosadghosh@ymail.com Guardian's Name : Ramprosad Ghosh Address1 : LAXMIPUR MATH,KANTAPUKUR,P.O.+DIST.-BURDWAN Address2 : PIN-713101

Date of Birth: 30-1-1993

Name of School/College or University of which he/she was a student prior to this admission:KALNA POLYTECHNIC

Particulars of AICTE Approved B.Sc/Diploma examinations passed.
(Attested copies of all documents should be attached) Examination DIPLOMA (NA) Year 2012 Board/Council W.B.S.C.T.E Marks -Aggr(%) 77.70 Class/Divn 1st

Submission Date: 2012-11-06 12:56:13

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The University has further accepted in principle that each and every student of the University shall be dutybound during the entire period of studentship with the University to immediately report to the authority any ragging is noticed either in University hostel or in University campus...2000 may be seen): 1.... 2. Checked and Forwarded by __________________________________________ Signature of Director / Principal / Teacher-in-charge Name of College/Institution ____________________ __________________________________________ College Code _______________________________ Date: ______________ Place __________________ _________________________________________ Full Signature of Guardian with date Seal ________________________________ West Bengal University of Technology APPROACH OF WEST BENGAL UNIVERSITY OF TECHNOLOGY TOWARDS RAGGING West Bengal University of Technology has accepted the guidelines issued by the Hon'ble Supreme Court in connection with judgement in Civil Writ Petition No.... Central Government and Others. published by Authority on Monday.. or causing hurt to any student or (b) asking any student to do any act..... Declaration and Undertaking by the Guardian I do hereby declare that I am fully aware of the above noted Approach of West Bengal University of Technology towards ragging and the statutory punishment to which a student shall be liable if found guilty of ragging and hereby undertake that my ward shall neither indulge in any kind of ragging activities nor shall take part in or subject anyone to ragging............... in the ordinary course. psychological or physiological harm or apprehension or shame or embarrassment to a student... Act XIII of 2000) which............... Full Signature of the Candidate Date: ..... contained the following provisions (for detail... ragging in any educational institution. Submission Date: 2012-11-06 12:56:13 ..............B...........Student Name : Smritikana Ghosh (Application ID : BGBL) Name of College/Institution where you have been admitted :_________________________________________________________________________________________ The particulars mentioned in page 1 of registration form are true to the best of my knowledge....... I shall abide by the rules & regulations of the West Bengal University of Technology.. be willing to do or perform... _________________________________________ Full Signature of student with date. which he/she would not. ........... or perform any thing.... 2000 (W... (b) Imprisonment of either description upto two years or fine upto five thousand rupees or both.. 3.... abet..... The University has also accepted the West Bengal Prohibition of Ragging in Educational Institutions Act.......' The Calcutta Gazette' Extraordinary. or is likely to cause any physical..................... inter alia......Provision of Ragging (a) Ragging within an educational institution is hereby prohibited.. 656 of 1998 filed by Vishwa Jagriti Mission Vs........ Declaration and Undertaking by the Candidate I do hereby declare that I am fully aware of the above noted Approach of West Bengal University of Technology towards ragging and the statutory punishment to which a student shall be liable if found guilty of ragging and hereby undertake that I shall neither indulge any ragging activities nor shall take part in or subject anyone to ragging.. if found guilty on enquiry by the institution against a complaint lodged by any other student. May 29.............. Page-2/2 .Penalty for Ragging (a) Expulsion from the educational Institution."Ragging" means the doing of any act which cause. or propagate...... and includes(a) testing or abusing of playing Practical joke on... (b) No person shall participate in... and shall not be readmitted to that educational institution... (c) Any student convicted under 3 (b) shall be dismissed from the educational institution in which he/she has been prosecuting his/her studies for the time being. Full Signature of the Guardian Date: .......

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