West Bengal StateUniversity
Berunanpukuria, P. O. Malikapur, PIN 700126
Barasat, North 24 Paraganas
(Do not send any document with this application form)
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Registration number (Instruction to fill up this number is given at the end of page 3)
Application form for Registration in B. ED Course for session 2020...
Name of the student:
Father/Mother/Husband/Guardian's name:
Present Address
Permanent Address
Date of Birth
Nationality
College code (3-digit code. Verify from the College
Authority)
Subject code (3-digit code. Verify from the list provided)
Gender
(Please Tick)
Male Female Religion
(1) (2) (Please Tick)
Hindu Muslim Christian
(1) (2) (3)
Others
(4)
Reservation Status (Please
Tick) Challenged Category
General (0)
SC
(1)
Physically Challenged(1)
ST
(2)
OBC General (4)
(3)
Visually Challenged(3)
PH
(5)
Cerebral Palsey(4)
Others (6)
Others (5)
Hearing Impaire(2)
EconomicallyChallenged Category
General 0
BPLCardHolder 1
APLCardHolder 2
Telephone Number
(Preferably Mobile )
Course of Study
Subject of Study: General Paper-I (Write Abbreviation)
General Paper-II (Write Abbreviation)
General Paper-III (Write Abbreviation)
Method Paper-IV (Write Abbreviation)
Method Paper-V (Write Abbreviation)
Special Paper-VI (Write Abbreviation)
LAST EXAMINATION PASSED: UNIVERSITY/BOARD
Name of the University/Board Roll
No.
Year
Division
Subject
Full Marks
Total
Marks Obtained
Declaration: Statements made above are true and correct and the documents furnished along with the form are genuine to the best of my knowledge and belief. In case any of the documents is subsequently detected to be fake or false, my Registration with the University shall be liable to be canceled. I, also declare that I shall obey the rules related to attendance and anti ragging programme framed by the University/College/UGC, otherwise disciplinary action will be taken against me. I understand that the Registration Fee to be received by the University is Rs.110/- (One hundred ten) only. Date: ............................................................. Signature of the Applicant (In Full) ____________________________________________________________________________ (For College Use Only) Statements made above verified and found to be correct Date:. .. . Signature of the Principal ____________________________________________________________________________
HowtofilluptheentriesintheRegistrationnumber?
First3digits(digitposition1,2and3)CollegeCode Next2digits(digitposition4&5)Yearofadmission(Here2011) Next3digits(digitposition6,7&8)Subjectcode(shouldstartwith1) Next1digit(digitposition9)Gender(either1or2) Next1digit(digitposition10)Religion(either1,2,3or4) Next1digit(digitposition11)Reservation(1,2,3,4,or5) Next1digit(digitposition12)ChallengedCategory(0,1,2,3,4,or5) Next1digit(digitposition13)EconomicallyChallengedCategory(0,1or2) Next 4 digits (digit position 14, 15, 16 & 17) Student's serial number as assigned by the College.
This is NOT the roll number of the candidates. Each student should be assigned a unique number by the College, starting from 0001 and running continuously without break
(Student's Foil) Sl.No................. Received one
filled
in
Registration
Form
Sri/Sm
....................................................................................... for the session 20..-20., along with the Registration fee. The candidate has taken admission in B.Ed. Date:........................... . Signature of the Official