ADMISSION APPLICATION VIEW FORM FOR ACADEMIC YEAR 2021 - 2023

Applicant Details

Application Sequence Number/User Id PG21052420

Applicant Name SHUBHADWEEP AICH

Date Of Birth 03/Aug/2000

Email Id SHUBHADEPAICH@GMAIL.COM

Mobile Number 7908169867

Country Of Birth India

Applicant Status Submitted

Personal Details
Gender Male

Marital Status Unmarried

Student's Caste Category Unreserved

Father's/Husband's/Guardian's
PRABIR AICH
Name

Mother's Name SWAPNA SARKAR AICH

Differently Abled No

Residential Status Indian

Religion Hindu

Current Address Details

Address Line 1 MANASHABARI,PALLIMANGAL,BHOLARDABRI,SOUTH JITPUR,ALIPURDUAR

Address Line 2 MANASHABARI,PALLIMANGAL,BHOLARDABRI,SOUTH JITPUR,ALIPURDUAR

Country India

State West Bengal

District Alipurduar

City/Town ALIPURDUAR JUNCTION

Pincode 736123

Permanent Address same as

Y
Current Address?
Permanent Address Details
Address Line 1 MANASHABARI,PALLIMANGAL,BHOLARDABRI,SOUTH JITPUR,ALIPURDUAR

Address Line 2 MANASHABARI,PALLIMANGAL,BHOLARDABRI,SOUTH JITPUR,ALIPURDUAR

Country India

State West Bengal

District Alipurduar

City ALIPURDUAR JUNCTION

Pincode 736123

Emergency Contact and Family Income Details

Emergency Contact Details 7908169867

Annual Income Rs 100000 - Rs 500000

Academic Details

MP/10th Std/Equivalent Examinaiton Details

Board/University Name West Bengal Board of Secondary Education

State West Bengal

Roll No 401881B 0038

Registration No 8151-029807

Registration Year 2015

Year of passing 2016

Percentage of Marks Obtained 80.86

HS/12th Std/Equivalent Examinaiton Details

Board/University Name West Bengal Council of Higher Secondary Education

State West Bengal

Roll No 170311 1551

Registration No 1161275554

Registration Year 2017

Year of passing 2018

Stream Arts

Percentage of Marks Obtained 86

Bachelor's Degree Details

Board/University Name Cooch Behar Panchanan Barma University

State WEST BENGAL

Roll No 1840011020071

Registration No 1800105010630

Registration Year 2018

Year of passing 2021

Qualifying Course BA
 Honours Subject Name English.

Percentage of Honours Marks

72.38
Obtained

MEd (Deputed) Course Details

Are you applying MEd (Deputed)
No
course?

Qualifying Entrance CAT/MAT/XAT Examination Details

Do you have a valid
CAT/XAT/CMAT/ATMA/MAT/GMAT/JEMAT No
score?

PG Course Details
Course English

PG Course/Program Name M.A. in English

PG Course M.A.

Center Preference
Center Details
Preference 1 Rampurhat College

Preference 2 Kalna College

Preference 3 The University of Burdwan

Preference 4 St. Xavier's College

Preference 5 Hooghly Mohsin College

Bank Details
Bank Name SBI-KIOSK BANKIN

Account Number 39586401983

IFSC Code SBIN0000005

Uploaded Documents
10th Mark sheet/Certificate
12th Mark sheet/Certificate
UG Mark sheet/Certificate.
10th Admit Card.

Declaration by the Applicant

I,     I hereby declare that I have carefully read the instructions. All particulars stated in this Registration Form are true and correct
to the best of my knowledge and belief. If any information provided is false or incorrect, I shall abide by the actions and
decisions taken by The University of Burdwan.