03/06/2013

Confirmation Slip

Victoria Institution (College)

"Accredited at the 'B' Level by NAAC" 78-B ACHARYA PRAFULLA CHANDRA ROAD, KOLKATA-700009 Phone No. : 033 2350 1959. Application No. : VIC13000191 Application for Admission to BENGALI Honours (2013-14) FOR OFFICE USE ONLY Roll No.: ________________ Combination : BNGA-HISG-JORG-ENGC-BNGM Checked & Verified Sd/For Department 1. Name in full 2. Date of Birth 3. Gender 5. Nationality 7. Category (General/SC/ST/OBC) 9. Physically Challenged 11. Year of passing H.S/Equivalent : SOHINI DAS : 5/6/1996 : Female : INDIAN : GENERAL : No : 2013 : History & Journalism : Bengali 4. Marital Status 6. Religion 8. State of Domicile 10. Blood Group : Unmarried : HINDUISM : WEST BENGAL : A+ Approved Sd/Sign. of the Principal SC N ST N PH N Shift : Day

Date : 03 June 2013

Elective Subjects according to preference Language group English (compulsory) and 12. Father's Name 13. Mother's Name 14. (a) Guardian's Name (b) Relationship 15. Occupation of Father / Guardian 16. Nearest Railway Station 17. Monthly Family Income 18. Address : (i) Permanent Address Address P.O. P.S City/Village District PIN Code Contact No. (ii) Communication Address Address P.O. P.S. City/Village District PIN Code Contact No.

: KISHORE DAS : SANKARI DAS : KISHORE DAS : FATHER : BUSINESS : SODEPUR : 10000

: 2NO. DESHBANDHU NAGAR, SODEPUR, 24 PGS (N) ,KOL-700110 : SODEPUR : KHARDAH : SODEPUR : NORTH 24 PARGANAS : 700110 : STD Code 91 Phone No 9330912029

: 2NO. DESHBANDHU NAGAR, SODEPUR, 24 PGS (N) ,KOL-700110 : SODEPUR : KHARDAH : SODEPUR : NORTH 24 PARGANAS : 700110 : STD Code 91 Phone No 9330912029
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03/06/2013

Confirmation Slip

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03/06/2013

Confirmation Slip

Application No. : VIC13000191

Application for Admission to BENGALI Honours (2013-14) RESULT OF QUALIFYING EXAMINATION

Date : 03 June 2013

Name : SOHINI DAS Result declared by your Board : PASSED Roll : 461521 No. : 0536 Year : 2013

Board : W.B.C.H.S.E Institution Name : SODEPUR CHANDRACHUR VIDYAPITH FOR GIRLS Institution Address : 1 NO. DESHBANDHU NAGAR, SODEPUR, KOL-700110 MARK SHEET Sl. No. Subject 1. 2. 3. 4. 5. 6. 7. ENGLISH BENGALI EDUCATION PHILOSOPHY POLITICAL SCIENCE HISTORY ENVS / EED / ES Full Marks Theory 100 100 100 100 100 100 40 Practical 0 0 0 0 0 0 60 30 30 30 30 30 30 10 Pass Marks Theory Practical 0 0 0 0 0 0 20 Marks Obtained Theory 50 50 78 60 46 46 26 Practical 0 0 0 0 0 0 51

Aggregate (of Top Four Subjects) : 59.50%

Effective Aggregate : 238.00

I hereby declare that all entries made by me in this form are true. If anything found not true, I understand that my candidature stands cancelled. I shall abide by the college rules regarding admission, class attendance, promotion criteria and stipulated qualifications for being sent up for final examination.

Full Signature of the Candidate with Date (Required at the time of admission)

Signature of the Parents / Guardian with Date (Required at the time of admission)

Documents to be Produced at the Time of Admission 1. 2. 3. 4. 5. 6. 7. 8. 9. Application Form Printout. (Only Original) 10+2 Level Mark Sheet and Admit Card. (Original & One self-signed Photocopy) 10th Level Mark Sheet and Admit Card. (Original & One self-signed Photocopy) SC/ST/Physically Challenged Certificate (if any). (Original & One self-signed Photocopy) School Leaving Certificate (Only Original) 2 copies of stamp sized colour photo. Monthly Income Certificate. (Relevant document from competent authority) Residential Certificate. (Original & One self-signed Photocopy) Duly paid Applicant's Copy of the Pay in Slip.

Sr. No. 1

Application History Submitted on 03-06-2013 at 7:49 pm

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03/06/2013

Confirmation Slip

PAY IN SLIP

Victoria Institution (College)

78-B ACHARYA PRAFULLA CHANDRA ROAD, KOLKATA-700009 Phone : 033 2350 1959. DATE: 03 June 2013 Application No. : VIC13000191 Name : SOHINI DAS AMOUNT : Rs. 100/- (Rupees One Hundred Only) Received Rs. 100/- (Rupees One Hundred Only) as application fees for admission to the 1st year B.A./B.Sc. Day Class at Victoria Institution (College), Kolkata. Honours: Bengali COLLEGE COPY

Signature with seal of Receiving Authority

Victoria Institution (College)

78-B ACHARYA PRAFULLA CHANDRA ROAD, KOLKATA-700009 Phone : 033 2350 1959. DATE: 03 June 2013 To be retained by the Applicant and to be produced at the time of admission. Application No. : VIC13000191 Name : SOHINI DAS AMOUNT : Rs. 100/- (Rupees One Hundred Only) Received Rs. 100/- (Rupees One Hundred Only) as application fees for admission to the 1st year B.A./B.Sc. Day Class at Victoria Institution (College), Kolkata. Honours: Bengali APPLICANT'S COPY

Signature with seal of Receiving Authority

NOTE: The Application Fee must be paid at the COLLEGE COUNTER from 11:00 AM TO 2:00 PM on any one of these dates 06/06/2013, 07/06/2013, 10/06/2013, 11/06/2013, 12/06/2013,13/06/2013 and 14/06/2013.

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