UNIVERSITY OF CALCUTTA

87/1, College Street, Kolkata - 700073, West Bengal, India

Application Form for Under Graduate Examinations

Date - 12/07/2021
Application Id. - 2100893237

Examination - B.Sc. SEMESTER - II (HONOURS) Examination (Under CBCS), 2021

To
The Controller of Examinations
University of Calcutta

Sir / Madam,
I request permission to present myself at the ensuing examination and furnish the required particulars as follows:

Name : AMINA PARVIN

Father's/ Guardian's Name : ANARUL HAQUE BAIDYA

Registration No. : 115-1215-0378-20
Roll No. : 203115-11-0114
Date of Birth : 02/04/2002
Physically Challenged : No
Gender : Female
Mobile : 8637854173
College Code : 115
E-mail : aminaparvin190@gmail.com
College Name : SURENDRANATH COLLEGE
Communication Address : VILL-PIFA, P.O-PIFA, P.S-BASIRHAT, City-BASIRHAT, Dist-NORTH 24 PGS, Pin-743422,743422

Subject(s)/Course(s) to appear & Fees to be deposited:

Srl. No. Subject Course Course Name COMPONENT Total Amount

Code Code
(TH/P/TU) Rs.
1 ZOOA CC3 NON CHORDATE -II (COELOMATE PHYLA) TH P 0.00
2 ZOOA CC4 CELL BIOLOGY TH P 0.00
3 CEMG GE2 PAPER 2 TH P 0.00
4 ENVS AECC2 ENVIRONMENTAL STUDIES TH - 0.00

Examination & other Fees to be deposited by the candidate to the College 0.00

*TH=Theory,P=Practical,TU=Tutorial Total 0.00

I declare that if any of the statement made in the above be found to be not true or if it appears that, in the opinion of the University, I
have contravened the provisions of the University Rules and Regulations relating to the examination to which I now seek
admission, my candidature for the examination shall be liable to be cancelled by the University.

Date: Full Signature of the applicant with Date

N.B.
1. Last date of submission of the form to the College by the Student - 22/07/2021
2. Students are required to submit the form to their College only.
3. For any change or correction, please contact your college.

CHALLAN COPY FOR STUDENT

Received an amount of Rs.0.00 from AMINA PARVIN having Registration No. 115-1215-0378-20 and Roll No.203115-11-0114 as
examination & other relevant fees for B.Sc. SEMESTER - II (HONOURS) Examination (Under CBCS), 2021, after proper verification
of all conditions including attendance as prerequisite of the candidate(as per extant regulation) to sit for the said examination.

Date: (Signature of dealing person with college seal)