Form No.

: 1070079

UNIVERSITY OF CALCUTTA
87/1, College Street, Kolkata - 700073, West Bengal, India
CU Website : www.caluniv.ac.in | Registration Website : www.calunivreg.in
Email : calunivregn@gmail.com | Phone No: (033) 22410071 Ext - 207/(033) 22190077
Registration Form For Post Graduate & Other Professional Courses
[ Other Than B.A. / B.Sc. / B.Com. (Honours / Major / General),
B.Mus. (Honours / General), BBA(Honours), BFA & BFAD ]
Student's Photo
1. CU Registration No. (For already Registered Candidate :

2. Name of the College/Institution/University Campu : INDIAN INSTITUTE OF SOCIAL WELFARE &

BUSINESS MANAGEMENT

3. Course of Study : M.B.A 4. Department : Business Management Student's Signature

5. Date of Admission to the College/Institution/University Campus : 16/04/2019

6. Session of Admission : 2019-20 7516-2381-5099
7. Whether Passed Previous Examination from Non Formal
: No
Education System (Approved by Distance Council of India or UGC) Aadhar No. (Optional)

8. Name : Lipika Haldar 16. Nationality : INDIAN

9. Father's Name : Sristidhar haldar 17. Whether Differently Abled : No

(a). Disability Code :
10. Mother's Name : shyamali haldar
(b). Percentage :
11. Guardian's Name : sristidhar haldar 18. Contact Mobile Number : 9073880902

12. Date of Birth : 12/03/1997 19. E-mail : haldar.lipika12@gmail.com

13. Gender : Female

20. Whether belongs to BPL : No
14. Religion : Hindu
21. Annual Family Income (In Rs) : 242000
15. Caste Category : SC
22. Locality Type : RURAL

23(a). Present Address : 23(b). Permanent Address :

Village Bhatenda, P.O+P.S Rajarhat, North 24 Parganas, near Village Bhatenda, P.O+P.S Rajarhat, North 24 Parganas, near
Rajarhat Doctor's club. Rajarhat Doctor's club.

Pin : 700135 State : West Bengal Country : India Pin : 700135 State : West Bengal Country : India

24. Furnish the details of subjects and marks obtained in the immediate previous qualifying level Examination(s) for the Post
Graduate / Professional Courses of Studies

A. Last Examination Name : B.Sc. in Hospitality and Hotel B. Last Examination Board/University : INDIRA GANDHI NATIONAL OPEN
Administration UNIVERSITY

C. Roll / Index number : 142842 D. Year of Passing : 2017

Subject(s) Studied Full Marks Marks Obtained Percentage (%) of Marks

Advance Food Production 1,100 855 77.73

Operations,Advance Food and
Beverage Operations,Front Office
Management,Accommodation
N.B. This Management,Food
Form with totaland fees of Rs. 165.00 /- to be submitted to the College/University through SBI Collect within one month from
Beverage
Management,Facility
the date of admission, failing the same late fine Rs. 50 /- should be submitted.
Planning,Research Project,
I do hereby declare that the statements made above are true and correct and the documents furnished along with the form are
genuine to the best of my knowledge and belief. In case any of the documents is subsequently detected to be fake or false, my
Registration with the University shall be treated as cancelled.

Date Full Signature of the Student

I do hereby certify that all the statements made above are verified and found to be true.

Date Signature of the Principal / Officer-in-Charge / Teacher-in-Charge /

Head of the Institution/ Vice Principal / Secretary Faculty Council with Seal
Form No. : 1070079

UNIVERSITY OF CALCUTTA
87/1, College Street, Kolkata - 700073, West Bengal, India
CU Website : www.caluniv.ac.in | Registration Website : www.calunivreg.in
Email : calunivregn@gmail.com | Phone No: (033) 22410071 Ext - 207/(033) 22190077
Registration Form For Post Graduate & Other Professional Courses
[ Other Than B.A. / B.Sc. / B.Com. (Honours / Major / General),
B.Mus. (Honours / General), BBA(Honours), BFA & BFAD ]
Receipt of Application for Registration
STUDENT'S COPY

Name : Lipika Haldar Name of the College / : INDIAN INSTITUTE OF SOCIAL WELFARE &
Institution / University Campus BUSINESS MANAGEMENT
Father's Name : Sristidhar haldar Department : Business Management

Mother's Name : shyamali haldar Course of Study : M.B.A

Guardian's Name : sristidhar haldar Date of Admission : 16/04/2019

Gender : Female Whether Belongs to BPL : No

Caste Category : SC Registration Fees Paid : 165.00

Differently Abled : No

Signature of the Principal / Officer-in-Charge / Teacher-in-Charge /

Date
Head of the Institution/ Vice Principal / Secretary Faculty Council with Seal