BEd Reg Form 2011

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Transcript of BEd Reg Form 2011

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    West Bengal State UniversityBerunanpukuria, P. O. Malikapur, PIN 700126

    Barasat, North 24 Paraganas(Do not send any document with this application form)

    Application form for Registration inB. ED Course for session 2020...

    Registration number (Instruction to fill up this number is given at the end of page 3)

    1 1 1

    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 CollegeAuthority)

    Subject code(3-digit code. Verify from the list provided) 1 4 1

    Affix Stamp

    Size

    Colour Photo

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    Gender(Please Tick)

    Male(1)

    Female(2)

    Religion(Please Tick)

    Hindu(1)

    Muslim(2)

    Christian(3)

    Others(4)

    Reservation Status (PleaseTick)

    SC(1)

    ST(2)

    OBC(3)

    General (4) PH(5)

    Others (6)

    Challenged

    Category

    General

    (0)

    Physically

    Challenged(1)

    Hearing

    Impaire(2)

    Visually

    Challenged(3)

    Cerebral

    Palsey(4)

    Others

    (5)

    Economically Challenged

    Category

    General

    0

    BPL Card Holder

    1

    APL Card Holder

    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)

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    LAST EXAMINATION PASSED: UNIVERSITY/BOARD

    Name of the University/Board

    Roll No. Year Division

    Subject Total

    FullMarks

    MarksObtained

    Declaration: Statements made above are true and correct and the documents furnished along withthe 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 programmeframed 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

    ____________________________________________________________________________

    How to fill up the entries in the Registration number?

    First 3 digits (digit position 1,2 and 3) College Code

    Next 2 digits (digit position 4 & 5) Year of admission (Here 2011)

    Next 3 digits (digit position 6,7 & 8) Subject code (should start with 1)

    Next 1 digit (digit position 9) Gender (either 1 or 2)

    Next 1 digit (digit position 10) Religion (either 1, 2, 3 or 4)

    Next 1 digit (digit position 11) Reservation (1, 2, 3, 4, or 5)

    Next 1 digit (digit position 12) Challenged Category (0,1, 2, 3, 4, or 5)

    Next 1 digit (digit position 13) Economically Challenged Category (0,1 or 2)

    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 numberby the College, starting from 0001 and running continuously without break

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    (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