Vidyasagar University Application Form for Admission to M.A
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GHATAL RABINDRA SATABARSIKI MAHAVIDYALAYA Affiliated to - VIDYASAGAR UNIVERSITY APPLICATION FORM FOR ADMISSION TO M.A. & M.SC COURSES 2019-20. SUBJECT: ROLL NO: SESSION: 2019-20 To The Principal/Teacher-in-Charge Ghatal Rabindra Satabarsiki Mahavidyalaya Affix passport P.o:-Ghatal, Dist:-Paschim Medinipur, size colour Pin:-721211. photography Sir, I beg to apply for admission to the Post-Graduate Course in …………………..........……………….………as a regular student for the session 2019-2020. (Subject) Yours Faithfully, Signature of the applicant. Date:……………………. 1. Name (in block letters) : 2. Father`s / Spouse`s Name : 3. Mother`s Name : 4. Statement of Marks obtained at different Examination: (With supporting documents duly attested) Name of the Board/Council/ Subject Year of Total Marks Percentage Division/ examination University Passing Marks Obtained of Marks Class. (1) (2) (3) (4) (5) (6) (7) (8) Madhyamik or Equivalent H.S. or Equivalent B.A./B.Sc./B.Com Hons. In………. 5. Date of Birth : (with supporting documents) 6. Permanent Address : (with PIN Code & Telephone/ Mob. No.): 7. Whether SC/ST/OBC-A/OBC-B : GEN SC ST OBC-A OBC-B (with supporting documents) (Please tick ( ) whichever applicable) Whether Physically Handicapped Yes No (if Yes, then PH………………………%) Category of PH………………………… Whether Trans gender Yes No Page 1 of 3 8. Sex : Male Female 9. Father`s / Mothers/ Spouse`s annual income : 10. Nationality : 11. Religion : 12. (i) Registration No. of this University : No…………………… Year……………………….. (ii) Name & Registration No. of the University last attended (in case of student migration from the other University) : 13. Any other information (with supporting documents) DECLARATION BY THE STUDENT 1. I do hereby declare that (a) the information provided in this form is true to the best of my knowledge and belief. If provided otherwise, I shall be punished as per rule; (b) I shall be a bonafide student of the college and I shall not be engaged in any employment or any other work or course of study elsewhere during the course for which I am applying. If proved contrary, my admission shall be liable to be cancelled; (c)If any of the above statement is incorrect or if it is found that I have in any way contravened the provision of the rules and regulations relating to the eligibility for prosecuting Post Graduate study or relating to the eligibility for taking the Examination after such study, my admission will liable to be cancelled and I shall not be entitled to get refund of fees paid by me; (d) I bind myself to abide by the code of conduct and discipline as may be enforced by the authorities from time to time; (e) If I do not attend lectures for 10(ten) consecutive teaching days from the date of commencement of class without prior information and valid reasons, my admission will be treated as cancelled; (f) I shall attend at least 75% of the total classes held in all Semesters. 2. I do hereby undertake that (a) I will not indulge any behaviour or act that may come under the definition of ragging; (b) I will not participate in or abet or propagate ragging in any from; (c) I will not hurt anyone physically or psychologically or cause any other harm; (d) I hereby agree that if I am found guilty of any aspect of ragging, I may be punished as per the provisions of the UGC Regulation and/ or as per the law in force. ................................................................. Signature of the applicant with date DECLARATION BY THE PARENT/ GURDIAN 1. I declare that (a) information given by my ward is correct; (b) In the event of his/ her being admitted to the University, I shall pay all his/her University dues, if any, till the completion of the course. 2. I do hereby undertake that (a) my son/daughter/ward will not indulge in any act of ragging; (b) if he/she is found guilty of any aspect of ragging, he/she may punished as per the provisions of UGC regulation and/or as per the law in force. ................................................................. Signature of father/mother/guardian with date OFFICE USE Roll No: ADMIT Date: Principal/Teacher-in-Charge Ghatal R. S. Mahavidyalaya Page 2 of 3 Received an Application from…………………………………...........………………………………….for admission to M.A/M.Sc course of Ghatal R. S. Mahavidyalaya in ………………………………........……………….for the session 2019-2020. (Subject) Date:…………………………….. Signature of Receiving Assistant & Office Seal No separate information will be sent to anyone. The Merit List of the candidate for the different courses will be displayed on the Notice Board of the University and website specifying the dates(s) for counselling and admission. Counselling and admission will be held on the same day. Any one failing to get himself/herself admitted on the specified date for any reason whatsoever will lose his/her right to admission and the vacancy will be filled up from the Merit List on the date of counselling. List of documents to be submitted 1. Self Attested Copy of all Mark Sheets. 2. Self Attested Copy of the Graduation Registration Certificate. 3. Self Attested Copy of the Birth Certificate (Ex. Madhyamik Admit) 4. Self Attested Copy of the SC/St/OBC-A/OBC-B Certificate (If applicable) 5. Self Attested Copy of the PH Certificate (If applicable) 6. Supporting documents (If applicable for any other information) Page 3 of 3 .