Senate of Serampore College Web Form ) Must Be Filled in and Send All Together to the Vice Principal Only

Serampore College FORM NO. 1 College founded by Carey, Marshman and Ward, 1818, Incorporated by Royal Charter, 1827, and Bengal Act of 1918, as modified Staple 5 upto Government of Passport size

West Bengal, 1997 Recent Theology Department Photographs P.O. Serampore, District: Hooghly, West Bengal – 712201

Application for the Admission of DIPLOMA IN BIBLE TRANSLATION

Language in which the course will be take n

(______)

IMPORTANT INSTRUCTIONS: a) Read the Application Form carefully and fill in all the entries clearly and legibly in English only. Incomplete and unclear application will be rejected. b) Attach all documents required as mentioned (wherever necessary) in the application form. c) The form duly filled in along with all the required documents must be sent to the ‘Vice – Principal, Theology Department, Serampore College, P.O. Serampore – 712201, Hooghly District, West Bengal’, and must reach on or before 7th December. d) 1st Installment Fees of Rs 5550/- in Demand Draft drawn in favour of PRINCIPAL, SERAMPORE COLLEGE payable at Serampore must be sent along with this form. e) Please note that the other forms included along with this i.e page 6 & 7 (Senate of Serampore College Web Form ) must be filled in and send all together to the Vice Principal only . Please do not send it to the Registrar, Senate of Serampore College)

1. Name of the Applicant in Full (in BLOCK LETTERS as per the Board/Degree Certificate)

______

2. Date of Birth ______/______/ ______(DD/MM/YYYY) 3. Sex ______(Attach attested copy of the Birth Certificate/Board Certificate as proof)

4. Father’s Name ______

5. Mother’s Name ______

6. Email ID ______

7. Permanent Address ______

Town/City ______District ______

State ______PIN ______

Phone ______Mobile ______8. Present Address ______

Town/City ______District ______

State ______PIN ______

Phone ______Mobile ______

9. Nationality ______11. Mother Tongue ______

12. Academic Record: List all examinations passed, starting from High School (attach attested copy of Mark Sheets and Certificates of all Examinations)

Sl. No Certificate /Degree Board/University Division Year

13. Name of the Tutor : ______

14. Name of the Organisation where the Tutor is working ______

______

15. State whether you have any experience in Translation work in the Past : ______

______

DECLARATION OF THE APPLICANT

I ______declare that all the information

given above are true and correct. I understand that any information which I have furnished

above, if proved to be false or incorrect, will automatically terminate my candidature.

Date: ______Signature of the Applicant

‘ LETTER OF RECOMMENDATION FORM NO. 2

CHURCH/ ORGANISTAIONAL RECOMMENDATION

APPLICANT’S INFORMATION ( To be filled in by the Applicant )

Name of the Applicant ______

REFERENCE (To be filled in by the Referee)

Name of the Referee ______

Address ______

City/Town ______District ______

State ______PIN ______

Phone ______Mobile ______Email ______

Name of Church/ Organization ______

Designation ______

1. Is the Applicant Recommended by the Church Leader or Leader of Bible Translating

Organisation ______

2. Write in brief the account of the applicant’s ministerial experience ______

______

Date: ______Signature of the Leader/Referee

‘ ADDITIONAL REFERENCES FORM NO. 3

The applicant should provide two (2) further references from persons who vouch for the character, gifting and motivation of the applicant.

1st REFEREE

Name of the Referee ______

Address ______

City/Town ______District ______

State ______PIN ______

Phone ______Mobile ______Email ______

Name of Church/ Organization ______

Designation ______

State the applicant’s suitability for the course ______

______

Date: ______Signature of the Referee

‘ ADDITIONAL REFERENCES FORM NO. 5

The applicant should provide two (2) further references from persons who vouch for the character, gifting and motivation of the applicant.

2nd REFEREE

Name of the Referee ______

Address ______

City/Town ______District ______

State ______PIN ______

Phone ______Mobile ______Email ______

Name of Church/ Organization ______

Designation ______

State the applicant’s suitability for the course ______

______

Date: ______Signature of the Referee

(For Office Use Only) Web Form Student ID: Degree / Diploma Course: Fees Paid:

Senate of Serampore College (University) Affix recent passport size FACULTY OF THEOLOGY photograph with Application for Registration signature over it Year of Registration………… Student ID (if exists)………. I. PERSONAL INFORMATION Name: (As per Highest Board / Council / Degree Certificate) Father’s Name: Mother’s Name: Spouse’s Name: Guardian’s Name:

Marital Status: M S O Gender: M F O Date of Birth: Male / Female / Other (attach document) Mother Tongue: Married / Single / Other dd mm yy Church Affiliation: Nationality:

II. ADDRESS FOR COMMUNICATION House No.: Locality.: City: District: State: Pin code: Email: Country: Phone No. Fax:

III. COURSE INFORMATION Course of Study: Tutor’s Name and Address: (If any)

Branch of Specialization : (If applicable) Medium of Examination: Name of College / Seminary /Federated Faculty:

IV. ACADEMIC (Attach marksheets and certificates)

Examination Name of University / College Y e a r of Registration Class/ Passed Board / School Attended Passing No. Grade

Name of the University from which migrating: (Please turn over) Declaration by the Student

I, …………………………………………………………………. hereby declare that, A) The information furnished by me in this registration form is true, complete and correct to the best of my knowledge and belief. B) I understand that in the event of any information given have been found false or incorrect at any stage, my candidature is liable to be rejected / cancelled. C) I undertake that in the event of any wrong statement or discrepancy in the statement furnished by me being detected even after my admission (and graduation), is liable to be terminated without any notice to me. D) I have read the rules and regulations pertaining to the Degree / Diploma course and shall abide by them and all other stipulations and decisions of the Senate of Serampore College and / or its Committees as applicable to me. E) I am neither engaged in nor am intending to undertake any course of study or employment in any other University / Institution / Organization while I am registered for the Course with the Senate of Senate of Serampore College. F) I understand that if I am engaged in / registered for any concurrent degree / diploma course of any other university, my registration shall be cancelled.

Date of Application:______Full Signature of Candidate

I hereby recommend the name of the above cited candidate for admission to the Course through the College / Seminary / Federated Faculty.

College Seal: Signature of College / Seminary Principal/Federated Faculty Registrar*

Date:______*Principal’s signature is not required for external Studies (BCS Direct Senate and Dip.C.S.)

Instructions

1. Required documents a. Marksheet in support of Educational qualification. b. Degree Certificate. c. Marksheet of Senate Qualifying Examination (If any). d. School Leaving Certificate as a proof for date of birth. e. Migration Certificate. f. Tutor’s Certificate (if needed). 2. Registration form submitted without the Fees, candidate’s full signature and all other relevant particulars asked there in will be rejected. 3. The tutor (applicable in case for B.C.S and Dip.C.S) must be a theologically qualified person who can guide the candidate. 4. Change of Name at the time of registration or later will be permitted only after submitting the court affidavit in original to the Senate. 5. All true copies of marksheet /certificates must be attested by the Principal of the affiliated College / Seminary or Registrar of the Federated Faculty after verifying the original personally. 6. Registration form must be filled in English by the candidate legibly in his / her own handwriting and for better computerized processing, use only capital letters. 7. The registration form together with all the enclosures and the prescribed fees (Drawn in favour of the Registrar, Senate of Serampore College by Bank Demand Draft payable at Serampore or Kolkata) should be sent UNDER REGISTERED POST WITH ACKNOWLEDGEMENT CARD at one time to the Registrar, Senate of Serampore College, P.O. Serampore 712201, Dist. Hooghly, West Bengal, India.