Aliah IIA/27, New Town, -700156 Email: [email protected] , [email protected] Phone: +91-8902084128 , 033-23416442 Website: www.aliah.ac.in

Affix Photograph Application Form for Admission in Size 3.5 cm × 4.5 cm

1. 5 - Year. Integrated MA/M.Sc. in………………………………….

2. 3 - Year BA (Hons.) in ………………………….

………………………… Full Signature of the Candidate 1. Name of the Candidate: ………………………………………………………………………………. 2. Date of Birth:

3. Quota(Tick): GEN PC (for PC category submit a certificate from appropriate authority). OS

4. Category: Gen OBC(A) OBC(B) SC ST

5. Sex: Male Female: 6. Marital Status: Married Unmarried

7. Received Kanyashree (For female candidates only): YES/NO ..…… if Yes, provide ID……………..……………..

8. Board/Council/University from which last examination passed (Tick):

WBBME HS ISC CBSE …………………………………………. College/University

9. Year of Passing:

10. Academic Qualification (Madhyamik onwards):

Level Examination Passed Board/Council/University Year of Passing % of Marks/ Division Grade Point

11. Father’s/ Guardian’s Name: …………………………………………………………………………………… 12. Name of Local Guardian: …………………………………………………………………………………….. 13. Permanent Address: …………………………………………………………………………………………..

Vill / City / Locality………………………………………………. P.O. …………………………………….

P.S. ……………… Dist …………………………….State…………………………Pin

Telephone

Mobile

1 14. Corresponding Address: ……………………………………………………………………………………….

Vill / City / Locality………………………………………………. P.O. …………………………………….

P.S. ……………… Dist …………………………….State…………………………Pin

Telephone

Mobile

15. Occupation of Father/Guardian ………………………………………………………………………………..

16. Family Monthly Income: Rs.

17. Nationality: …………………………………….

18. College or School Last Attended: …………………………………………………………

19. Blood Group: …………………………………………………….

DECLARATION

I ………………………………………………………………, hereby declare that the information furnished be me is correct and complete in all respect. I understand that my application/admission will be rejected/cancelled with no further communication whenever any discrepancy (incomplete application/incorrect information/non-fulfillment of eligibility criteria) is detected.

2. For non-compliance of the above I shall be solely responsible and agree to any disciplinary action taken by the authority.

…………………………………………..

Signature of the Candidate Place: Date:

Document need to submit at the time of application: 1. Self-attested copies of Marksheets, Proof of Age and PC/OS Certificate (where applicable). 2. Demand Draft 0f Rs.- 500/-(for male) and Rs.-300/-(for female) in favour of ALIAH UNIVERSITY Payable at KOLKATA. 3. Kindly write in CAPITAL LETTER ‘’Application for admission to ………(name of the subject)……….” in the envelope.

Send your application to The Chairman, AUAT Office, Aliah University, 2nd Floor, IIA/27, New Town, , Kolkata-700156. Email: [email protected], [email protected] Phone: +91-8902084128, 033-23416442

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