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Te Ct VIDYASAGAR UNIVERSITY Rs. 40.00 Midnapore—721 102, West Bengal APPLICATION FORM FOR REGISTRATION IN THE P.G. COURSES (Both for Miges 1, Name of the candidate in English script (Write in block letters as recorded in the Madhyamik or equivalent examination) 2, Name ofthe candidate in Bengali script 3. (a) Father's Name (6) Mother's Name 4. Date of Birth (as recorded in the Madhyamik or equivalent examination) 5. Permanent address 6. Nationality apd Nowe Migoome sete 1 MaIMr/Miss. SHREY KUMAR SHAW : eq PAA + RATESH SHAW 7 LAXME SHAW + 13/04/2000 1168 PURBACHAL KALI TALA FOOOFE + DNOLAN AOAD, KOLKATA — 7. Details of admission to the Undergraduate Course ofthe Vidyasagar Universiy/Other University a) Name of the Course b) Session & date of admission ) Name ofthe College! Institution 4) Year of Passing 8. Details of admission to the postgraduate course of Vidyasagar University. 3) Name ofthe course ‘b) Session 6) Department 4) Date of admission €) Roll No. 9, Areyoua migrating student? If yes, please mes a) N fame of University! Institution last attended ») Registration No. ofthat University with year HOA 2023 - 2024 HOA tion pusvenszty OF CALCUTTA Gig ~~ 06 Uk —14, (2014) it F = 21-0465, (2022) €) Last Examination passed with Roll No. & year : {@\Ol6 - 21-O'65", 4) Migration Certificate No. with date ofissue : $3536 /oR6- III ~ 0514 - 19 10. Details of fees deposited at Cash Counter with 30 May , 2025 Callan (Enclosed the : 1 MobNo ESP) 1 SF FFOE2IIE bibs -coen 22. Emailid 1 ghaey-horan 28-258 Bibs -co sn ee Shey Human Shaw (Signature ofthe applicant in full) Memo No Forwarded after verification of all information furis Date: 1. Registration No...... Session. ee efOt Office Asst. shed by the applicant. Signature of Secy., P.G. Council! Principal with Seal For use in the Registrar's Department Fhe year . Registration is recorded during the ssnCollege/Universty Office Supdt. Dy. 7 Registrar Dowricaded from Vidyasagar Univers by 4937 2144 on 24 December 2020: 1248.01; Copyright: Vidyasagar University pte vyasagar ac n/Doanicadu'ShonPelexpetlenfermsprolormalUG_PG.ReseurchREG_Fom_PG pat SI. No. .... MIGRATION CERTIFICATE 3536/046-1111-0514-19 Memo. no. M-RiCert ..22s0046-UItI)

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