confirmation slip

03/06/2013 Confirmation Slip

www.victoriacollegeadmissions.com/UG2013/ApplyUG2013/day/printForm.php 1/4

SC N ST N PH N

Victoria Institution (College)"Accredited at the 'B' Level by NAAC"

78-B ACHARYA PRAFULLA CHANDRA ROAD, KOLKATA-700009

Phone No. : 033 2350 1959.

Shift : Day

Application No. : VIC13000191Application for Admission to

BENGALI Honours (2013-14)Date : 03 June 2013

FOR OFFICE USE ONLY

Roll No.: ________________

Combination : BNGA-HISG-JORG-ENGC-BNGM

Checked & Verified

Sd/-

For Department

Approved

Sd/-

Sign. of the Principal

1. Name in full : SOHINI DAS

2. Date of Birth : 5/6/1996

3. Gender : Female 4. Marital Status : Unmarried

5. Nationality : INDIAN 6. Religion : HINDUISM

7. Category (General/SC/ST/OBC) : GENERAL 8. State of Domicile : WEST BENGAL

9. Physically Challenged : No 10. Blood Group : A+

11. Year of passing H.S/Equivalent : 2013

Elective Subjects according to preference : History & Journalism

Language group English (compulsory) and : Bengali

12. Father's Name : KISHORE DAS

13. Mother's Name : SANKARI DAS

14. (a) Guardian's Name : KISHORE DAS

(b) Relationship : FATHER

15. Occupation of Father / Guardian : BUSINESS

16. Nearest Railway Station : SODEPUR

17. Monthly Family Income : 10000

18. Address :

(i) Permanent Address

Address : 2NO. DESHBANDHU NAGAR, SODEPUR, 24 PGS (N) ,KOL-700110

P.O. : SODEPUR

P.S : KHARDAH

City/Village : SODEPUR

District : NORTH 24 PARGANAS

PIN Code : 700110

Contact No. : STD Code 91 Phone No 9330912029

(ii) Communication Address

Address : 2NO. DESHBANDHU NAGAR, SODEPUR, 24 PGS (N) ,KOL-700110

P.O. : SODEPUR

P.S. : KHARDAH

City/Village : SODEPUR

District : NORTH 24 PARGANAS

PIN Code : 700110

Contact No. : STD Code 91 Phone No 9330912029



Application No. : VIC13000191Application for Admission to

BENGALI Honours (2013-14)Date : 03 June 2013

RESULT OF QUALIFYING EXAMINATION

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. SubjectFull Marks Pass Marks Marks Obtained

Theory Practical Theory Practical Theory Practical

1. ENGLISH 100 0 30 0 50 0

2. BENGALI 100 0 30 0 50 0

3. EDUCATION 100 0 30 0 78 0

4. PHILOSOPHY 100 0 30 0 60 0

5. POLITICAL SCIENCE 100 0 30 0 46 0

6. HISTORY 100 0 30 0 46 0

7. ENVS / EED / ES 40 60 10 20 26 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. Application Form Printout. (Only Original)

2. 10+2 Level Mark Sheet and Admit Card. (Original & One self-signed Photocopy)

3. 10th Level Mark Sheet and Admit Card. (Original & One self-signed Photocopy)

4. SC/ST/Physically Challenged Certificate (if any). (Original & One self-signed Photocopy)

5. School Leaving Certificate (Only Original)

6. 2 copies of stamp sized colour photo.

7. Monthly Income Certificate. (Relevant document from competent authority)

8. Residential Certificate. (Original & One self-signed Photocopy)

9. Duly paid Applicant's Copy of the Pay in Slip.

Sr. No. Application History

1 Submitted on 03-06-2013 at 7:49 pm



PAY IN SLIP

Victoria Institution (College)78-B ACHARYA PRAFULLA CHANDRA ROAD, KOLKATA-700009

Phone : 033 2350 1959.

DATE: 03 June 2013 COLLEGE COPY

Application No. : VIC13000191 Honours: Bengali

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. 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 APPLICANT'S COPY

To be retained by the Applicant and to be produced at the time of admission.

Application No. : VIC13000191 Honours: Bengali

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. Signature with seal of Receiving Authority

NOTE: The Application Fee must be paid at the COLLEGE COUNTERfrom 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.