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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 patSI. No. ....
MIGRATION CERTIFICATE
3536/046-1111-0514-19
Memo. no. M-RiCert ..22s0046-UItI)