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St.

Xaviers College (Autonomous)


Under Department of Political Science
30, Mother Teresa Sarani (Park Street), Kolkata 700 016
Phone: +91 33 2255 1288/89, e-mail: careersxc@gmail.com
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Gender
E-mail Address
Employment Status Do you belong to any of the following categories?
Date:
Place: Signature of the Candidate
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Details of Completed Educational Qualifications
Qualification Examination Name, Institution Name, City Stream/Honours Year of Passing Grade/ Percent
Intermediate/10+2
Graduation
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Details of Currently Pursuing Educational Qualifications
Qualification Examination Name, Institution Name, City Stream/Honours Roll No
Year of
Appearing
Details of Employment, If Any
Name of Present Employer (with address and Contact No.) Designation Experience
Under Graduate Course in Human Rights ducation
COLLEGE I.D. CARD FORM
St. Xavier's College (Autonomous)
30, Mother Teresa Sarani, Kolkata 700016
Phone : 22875995/22551288
Website : www.sxccal.edu
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Telephone (with STD Code)
E-mail Address
Blood Group
Signature _____________________________________________________
Date of Birth
Roll No.
Course
Under Graduate Course in Human Rights Education
Session August 2013
DEPARTMENT OF POLITICAL SC.
Date: ....................................
St. Xaviers College (Autonomous)
30, Mother Teresa Sarani, Kolkata - 700016
Demand Draft/ Pay Order No. ................................
STUDENTS COPY
Paid to the credit of St. Xaviers College A/c No. 95852010004418 as per details above
Name of the Candidate
Payment Type
DEPARTMENT OF POLITICAL SC.
Date: ....................................
St. Xaviers College (Autonomous)
30, Mother Teresa Sarani, Kolkata - 700016
INSTITUTIONS COPY
Paid to the credit of St. Xaviers College A/c No. 95852010004418 as per details above
Name of the Candidate
DEPARTMENT OF POLITICAL SC.
Date: ....................................
St. Xaviers College (Autonomous)
30, Mother Teresa Sarani, Kolkata - 700016
BANKS COPY
Paid to the credit of St. Xaviers College A/c No. 95852010004418 as per details above
Name of the Candidate
Verified by:________________________ Cashier:________________________
Verified by:________________________ Cashier:________________________
Verified by:________________________ Cashier:________________________
Payment Type
Demand Draft/ Pay Order No. ................................
Payment Type
Demand Draft/ Pay Order No. ................................
Course
Under Graduate Course in Human Rights Education
Session AUG-13
Amount
Roll No.
Course Under Graduate course in Human Rights Education
Session AUG-13 Roll No.
Course Under Graduate course in Human Rights Education
Session AUG-13 Roll No.
Amount
Amount
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Demand Draft/ Pay Order
Cash
Demand Draft/ Pay Order
Cash
Demand Draft/ Pay Order

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