8/5/22, 1:15 PM Invoice Receipt

APPLICATION FOR ADMISSION TO THE B.A. / B.SC. / B.COM. (HONS. & GEN.) COURSE 1ST SEMESTER SESSION : 2022 – 2023

FOR OFFICE USE Application Id : BR22013757

Application Date : 05/08/2022 01:14 PM
Date of Admission : Course : Print Date : 05/08/2022 01:15 PM

Class : Subject :
Student’s Id :
Roll No :
......................................... .........................................
Signature Signature

PERSONAL PART

Shift : Day
1. Name (in Block Letters) : MONALISHA SARKAR 2. Date of Birth : 12/11/2003
3.a. Vill. : Purulia b. P.O : Purulia
c. P.S. : Purulia d. Dist : Purulia
e. State. : West Bengal f. Pin : 723101
4. Contact No. : 7478883198 5. Nationality : Indian
6. Religion : Hinduism 7. Minority : No
8. Gender : Female 9. Caste / Category : General
10. Sub Caste : 11. Physically Handicapped : No
12. Father's Name : Mangal Sarkar 13. Father's Qualification : Madhyamik
14. Mother's Name : Molina Sarkar 15. Mother's Occupation : Housewife
16. Guardian's Name : Mangal Sarkar 17. Guardian's Occupation : Businessman
18. Relation with Guardian : FATHER 19. Marital Status : Unmarried

ACADEMIC PART

20. H.S.Roll No./Index No. : 3001211132 21. Year of Passing : 2022

22. Name of Council/Board : West Bengal Council of Higher Secondary Education
23. Name of the School : Santamoyee Girl's High School
24.Total Marks in MP or Equ : 700 25. Marks Obtained : 377
26.Percentage of MP or Equ : 53.8571428571429

27. Statement of marks obtained in the H.S./Equivalent Examination

Modern Computer
Subject English Bengali History Philosophy Geography
Application
Full Marks 100 100 Theory Theory Theory Theory
100 100 100 100
Marks Obtained 73 75 86 62 93 84

APPLICATION PART

28. Subject(s) Applied for :

Compulsory Subject
Srl. No. Stream Course Type Honours Subject Generic Elective Subject Honours Marks Merit Point
(AECC)
1 B.A Honours Bengali Philosophy Environmental Studies 75 286.0571
2 B.A Honours Philosophy Bengali Environmental Studies 93 470.0571
3 B.A Honours English History Environmental Studies 73 282.0571

Declaration by the Candidate :I do hereby declare that the above particulars are true to the best of my knowledge and belief and no relevant information are suppressed or omitted. I do hereby declare also that I shall
not be allowed to fill up the form for University Examination unless I secure at least 75% class attendance as per Regulations of the Burdwan University. I promise to abide by the rules and regulations of the College.
Date :
............................................................
Signature of Candidate
Declaration by the Father/Guardian :I do hereby certify that the applicant has taken my permission to seek admission in BURDWAN RAJ COLLEGE, West bengal and also the statements made therein are to the
best of my knowledge based on fact.
Date :
............................................................
Signature of Father/Guardian
FOR OFFICE USE Admit Verified

Principal/ Teacher-in-Charge Signature

onlineadmissionbrc.org.in/frmForm.aspx 1/2
8/5/22, 1:15 PM Invoice Receipt

onlineadmissionbrc.org.in/frmForm.aspx 2/2