UTKAL UNIVERSITY OF CULTURE,BHUBANESWAR

APPLICATION FORM FOR EXAMINATION

Reg No : 2003052 Roll No : 03BVA20052

Name of the college : B.K.College of Art and Craft

Course : Bachelor of Visual Art (BVA)
Exam Type : REGULAR
Session : 2022-23

Applicant's Information :
1. Applicant Name : SANGITA NAIK

2. Gender : Female 3. Nationality : Indian

4. Date of Birth (In Figure) : 26-07-2002

5. Category :

6. (a) Father's Name : KARUNAKARA NAIK

(b) Mother's Name : NANDINI NAIK

7. Applicant's Email : sn8167066@gmai.com

8. Details of the Current Semester :

Discipline : Art History (AHI)

Semester : 5TH

Year : 2023

Subjects of Examination :
Paper Code Core/Elective Title
BVA501 CORE Art History : India and the West
BVA502 CORE Aesthetics : India and the West
BVA503 CORE Far Eastern Art-1
BVA504 CORE Critical Writing and Documentation
BVA505 CORE Dissertation and Viva
BVA506 ELECTIVE Print Making

9. Payment Details :
Amount : 500.00 Transaction ID : DUL1378091 Date : 29-06-2023

Declaration by the Applicant

(a) I submit all the particulars for consideration by the university authorities to admit me for the examination.
(b) I shall not indulge in any undesirable activities which will affect the prestige of my institution of study or of Utkal university of culture.
The university authorities may impose any punishment for any contravention to rules and regulations in force in the
conduct of examination.

Full Signature of the Aplicant

 CERTIFICATE

(A) Certified (1) that the particulars given overleaf by the candidate are correct, ( 2 ) that I have verified
his/her certificates of the qualifying examination and the registration receipt in original (3) that his/her
conduct has been good, (4) that he/she has studied diligently and (5) that he/she has satisfactorily passed
the college periodical examinations and other tests and there is all probability of his/her passing the
examination. Nothing is known to me against his/her moral character (6) that the candidate has secured the
percentage of attendance. (7) that the fees prescribed by the university has been paid by the candidate and
deposited.

(B) In case of Back appearance) Certified that

sri/Smt.____________________________________________
appeared in Examination in _________________________________ with Roll No. ___________________
as Back paper(s).(The Original Fail Certificate to be attached)

(C) (In case of candidates who had already appeared) Certified that the results of the candidate has not been
withheld of he/she has not been debarred from appearing at the present Examination for being reported to
have infringed the rules of examination discipline.

Seal Principal ___________________________

College B.K.College of Art and Craft

Date & time of submission : 29-06-2023 07:56 PM

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