UNIVERSITY OF CALCUTTA

87/1, College Street, Kolkata - 700073, West Bengal, India

Application Form for Under Graduate Examinations

Date - 14/06/2022
Application Id. - 2201418500

Examination - B.A. SEMESTER - IV (HONOURS) Examination (Under CBCS), 2022

To
The Controller of Examinations
University of Calcutta

Sir / Madam,
I request permission to present myself at the ensuing examination and furnish the required particulars as follows:

Name : PRITI MAITY

Father's/ Guardian's Name : PRABHAT MAITY

Registration No. : 052-1211-0088-20
Roll No. : 202052-11-0029
Date of Birth : 26/05/2003
Physically Challenged : No
Gender : Female
Mobile : 9748004600
College Code : 052
E-mail : priti26052003@gmail.com
College Name : DINABANDHU ANDREWS COLLEGE, GARIA
Communication Address : 5/41 RAMKRISHNA BHAVAN NETAJI NAGAR NSC BOSE ROAD,700093

Subject(s)/Course(s) to appear & Fees to be deposited:

Srl. No. Subject Course Course Name COMPONENT Total Amount

Code Code
(TH/P/TU) Rs.
1 ENGA CC8 BRITISH LITERATURE (18TH CENTURY) TH TU -

2 ENGA CC9 BRITISH ROMANTIC LITERATURE TH TU -

3 ENGA CC10 19TH CENTURY BRITISH LITERATURE TH TU -

4 ENGA SEC-B1 CREATIVE WRITING TH T -

5 PLSG GE4 INTERNATIONAL RELATIONS TH TU -

Examination & other Fees to be deposited by the candidate to the College 355.00

*TH=Theory,P=Practical,TU=Tutorial Total 355.00

I declare that if any of the statement made in the above is found to be untrue or if it appears that, in the opinion of the University, I
have contravened the provisions of the University Rules and Regulations relating to the examination to which I now seek
admission, my candidature for the examination shall be liable to be cancelled by the University.

Date: Full Signature of the applicant with Date

N.B.
1. Last date of submission of the form to the College by the Candidate - 22/06/2022
2. Candidates are required to submit the form to their College only.
3. For any change or correction, please contact your college.

CHALLAN COPY FOR CANDIDATE

Received an amount of Rs.355.00 from PRITI MAITY having Registration No. 052-1211-0088-20 and Roll No.202052-11-0029 as
examination & other relevant fees for B.A. SEMESTER - IV (HONOURS) Examination (Under CBCS), 2022, after proper verification
of all conditions including attendance as prerequisite of the candidate(as per extant regulation) to sit for the said examination.

Date: (Signature of dealing person with college seal)