Provisional Admission Form for 1st Year (Session 2021-22)

Dr. Meghnad Saha College

Ranipur, Itahar, Uttar Dinajpur, pin: 733128
Affiliated to Gour Banga University

Application Number: DMS2103219 Name: RAM DAS

For Office Use Only
Roll No: Section: Ackd No: Student Id No:

Order of Principal Verified By Date

Streams Types Combination Merit
Arts Honours Bengali DC-Geography GE1-Political Science GE2 73.3300
Arts General Sanskrit DC1-Education DC2-History GE 365.0000
Student: Male || General || Hindu || || PWD:None Date of Birth: 01/Jan/2000
email: sefalidebnath52@gmail.com Mobile: 9856322154 Aadhaar Card: 986532451232
Father: SAM DAS Mother: PRIYA DAS Guardian: SAM DAS
Annual Income: 60000 Guardian’s Occupation: Business Guardian’s Phone: 8754123265
Address: KALIYAGANJ, Uttar Dinajpur,733129
HS Board: WEST BENGAL COUNCIL OF HIGHER SECONDARY EDUCATION, KOLKATA - Passing Year: 2021
HS School: - HS Roll: 1402121053
Subjects Name Full Marks % scored
Bengali 100 75.0000
English 100 74.0000
Geography 100 65.0000
Computer Appliance 100 76.0000
History 100 69.0000
Political Science 100 71.0000
Grand % = 73.0000 Grand Total = 365
DECLARATION OF THE APPLICANT
(a) All the statements in the application are true and correct to the best of my knowledge. If any information provided by me is found to be untrue or if it appears
that (in the opinion of the college administration) I have in any way contravened the Rules and Regulations of the college, my admission will be liable to be
cancelled (b) If I fail to start attending college within ten days after the date of commencement of classes without satisfactory ground and proper information,
the college will have every right to strike off my name from the college attendance registers for the students. (c) I also vow to attend 75% of the total classes in
each subject as per Calcutta University norms.
DECLARATION OF THE GUARDIAN
I shall be prepared to remove my ward from the college if the College Authority considers it necessary on disciplinary or other grounds. Further, I give the
assurance that my ward will fully obey the rules and regulations framed by the College Authority from time to time.

Signature of the Applicant Signature of the Guardian

Printed on 2021-08-06 09:35:17

DMS2103219

Powered by TCPDF (www.tcpdf.org)