Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
5. Sex : Male Female Other (give tick mark) 6. Marital Status : Married Unmarried (give tick mark)
7. Date of Birth : ...................................................................................
(Enclose supporting document)
8. (a) Are you employed any where in any (give tick mark)
capacity ? : Yes No
(b) If yes, give details including the
name and address of the employer : ...................................................................................
(also Phone No. & e-mail)
9. Institution / College you last attended : ..................................................................................
I understand that if at any stage during the course it is found that I did not passess the required eligibility for
admission, or if I do anything in violation of the University Act, Status, Ordinances, Regulations or other rules
framed through administrative power, I shall be liable to any disciplinary action deemed fit by the Directorate of
Vidyasagar University.
............................................................
Date ....................................
Signature of the Candidate
STUDENT INFORMATION SHEET
Students are required to furnish the following information
2. Study Centre :
Name with Code
3. Subject :
4. Name :
(In block Letter)
5. S/O/D/O :
8. Belong to SC/ST/OBC/
Minority : SC ST OBCA OBCB Minority (give tick mark)
9. Academic Qualification :
B.A. B.Com. BSc. Two years Pass Three years Pass General/Hons.
(others, if any)
ii) e-mail :
DIRECTORATE OF DISTANCE EDUCATION DIRECTORATE OF DISTANCE EDUCATION DIRECTORATE OF DISTANCE EDUCATION DIRECTORATE OF DISTANCE EDUCATION
VIDYASAGAR UNIVERSITY, MIDNAPORE VIDYASAGAR UNIVERSITY, MIDNAPORE VIDYASAGAR UNIVERSITY, MIDNAPORE VIDYASAGAR UNIVERSITY, MIDNAPORE
Challan for Admission in the Part-I Session-2017-18 Challan for Admission in the Part-I Session-2017-18 Challan for Admission in the Part-I Session-2017-18 Challan for Admission in the Part-I Session-2017-18
[Give a tick on the opted subject] [Give a tick on the opted subject] [Give a tick on the opted subject] [Give a tick on the opted subject]
Name :- Name :- Name :- Name :-
Study Centre:- Code Study Centre:- Code Study Centre:- Code Study Centre:- Code
Stream:- [MA/M.Sc / M. Com] Subject:- Stream:- [MA/M.Sc / M. Com] Subject:- Stream:- [MA/M.Sc / M. Com] Subject:- Stream:- [MA/M.Sc / M. Com] Subject:-
Roll:- No.:- Roll:- No.:- Roll:- No.:- Roll:- No.:-
Sl. Subject Part-I Sl. Subject Part-I Sl. Subject Part-I Sl. Subject Part-I
No. No. No. No.
01. M.A. (Bengali, English, History, Total Fees 4500* 01. M.A. (Bengali, English, History, Total Fees 4500* 01. M.A. (Bengali, English, History, Total Fees 4500* 01. M.A. (Bengali, English, History, Total Fees 4500*
Pol.Sc., Sanskrit) Late fee 200 Pol.Sc., Sanskrit) Late fee 200 Pol.Sc., Sanskrit) Late fee 200 Pol.Sc., Sanskrit) Late fee 200
02. M.Com Total Fees 4500* 02. M.Com Total Fees 4500* 02. M.Com Total Fees 4500* 02. M.Com Total Fees 4500*
Late fee 200 Late fee 200 Late fee 200 Late fee 200
03. M.Sc. (Env. Science, Zoology, Total Fees 20350* 03. M.Sc. (Env. Science, Zoology, Total Fees 20350* 03. M.Sc. (Env. Science, Zoology, Total Fees 20350* 03. M.Sc. (Env. Science, Zoology, Total Fees 20350*
Botany, Geography) Sponsred Candidate Botany, Geography) Sponsred Candidate Botany, Geography) Sponsred Candidate Botany, Geography) Sponsred Candidate
(only Env. Science) 26350 (only Env. Science) 26350 (only Env. Science) 26350 (only Env. Science) 26350
Late Fees 200 Late Fees 200 Late Fees 200 Late Fees 200
04. M.Sc. (Physics) Total Fees 19750* 04. M.Sc. (Physics) Total Fees 19750* 04. M.Sc. (Physics) Total Fees 19750* 04. M.Sc. (Physics) Total Fees 19750*
Late fee 200 Late fee 200 Late fee 200 Late fee 200
05. M.Sc. (Applied Mathematics with 05. M.Sc. (Applied Mathematics with 05. M.Sc. (Applied Mathematics with 05. M.Sc. (Applied Mathematics with
Total Fees 12750* Total Fees 12750* Total Fees 12750* Total Fees 12750*
Oceanology and Computer 200 Oceanology and Computer 200 Oceanology and Computer 200 Oceanology and Computer 200
Late fee Late fee Late fee Late fee
Programming) Programming) Programming) Programming)
06. M.Sc. (Chemistry) Total Fees 22250* 06. M.Sc. (Chemistry) Total Fees 22250* 06. M.Sc. (Chemistry) Total Fees 22250* 06. M.Sc. (Chemistry) Total Fees 22250*
Late fee 200 Late fee 200 Late fee 200 Late fee 200
* A candidate seeking admission in desired stream for Part-I * A candidate seeking admission in desired stream for Part-I * A candidate seeking admission in desired stream for Part-I * A candidate seeking admission in desired stream for Part-I
will be required to deposit the amount will be required to deposit the amount will be required to deposit the amount will be required to deposit the amount
** An additional amount of Rs- 350/- need to be paid as ** An additional amount of Rs- 350/- need to be paid as ** An additional amount of Rs- 350/- need to be paid as ** An additional amount of Rs- 350/- need to be paid as
processing charge. processing charge. processing charge. processing charge.
Total Amount (in Rs.) ________________ Total Amount (in Rs.) ________________ Total Amount (in Rs.) ________________ Total Amount (in Rs.) ________________
In words __________________________________ In words __________________________________ In words __________________________________ In words __________________________________
Payment mode:- [Give a Tick on the opted mode of payment] Payment mode:- [Give a Tick on the opted mode of payment] Payment mode:- [Give a Tick on the opted mode of payment] Payment mode:- [Give a Tick on the opted mode of payment]
1. By cash:- Branch Name _________ date __/__/____ 1. By cash:- Branch Name _________ date __/__/____ 1. By cash:- Branch Name _________ date __/__/____ 1. By cash:- Branch Name _________ date __/__/____
(Cash can only be deposited in S/B A/C No.-17480100002028 of (Cash can only be deposited in S/B A/C No.-17480100002028 of (Cash can only be deposited in S/B A/C No.-17480100002028 of (Cash can only be deposited in S/B A/C No.-17480100002028 of
Directorate of Distance Education, Vidyasagar University, Midnapore Directorate of Distance Education, Vidyasagar University, Midnapore Directorate of Distance Education, Vidyasagar University, Midnapore Directorate of Distance Education, Vidyasagar University, Midnapore
at UCO Bank, Vidyasagar University Branch) at UCO Bank, Vidyasagar University Branch) at UCO Bank, Vidyasagar University Branch) at UCO Bank, Vidyasagar University Branch)
OR OR OR OR
2. By Draft:-(DD can be made from any nationalized bank) 2. By Draft:-(DD can be made from any nationalized bank) 2. By Draft:-(DD can be made from any nationalized bank) 2. By Draft:-(DD can be made from any nationalized bank)
a. Bank Name- a. Bank Name- a. Bank Name- a. Bank Name-
b. Branch Name- b. Branch Name- b. Branch Name- b. Branch Name-
c. DD No.- c. DD No.- c. DD No.- c. DD No.-
d. Date:- d. Date:- d. Date:- d. Date:-
Sign. of the applicant Sign. of the applicant Sign. of the applicant Sign. of the applicant
Received the amount Rs. .............................................................. Received the amount Rs. .............................................................. Received the amount Rs. .............................................................. Received the amount Rs. ..............................................................
Date ......................... Signature & Stamp of Bank / Study Centre Date ......................... Signature & Stamp of Bank / Study Centre Date ......................... Signature & Stamp of Bank / Study Centre Date ......................... Signature & Stamp of Bank / Study Centre
Note: Note: Note: Note:
1. To be filled in by the applicant and deposited in cash or by Draft 1. To be filled in by the applicant and deposited in cash or by Draft 1. To be filled in by the applicant and deposited in cash or by Draft 1. To be filled in by the applicant and deposited in cash or by Draft
at UCO BANK, V.U. Branch (For Admission in Head Quarter). at UCO BANK, V.U. Branch (For Admission in Head Quarter). at UCO BANK, V.U. Branch (For Admission in Head Quarter). at UCO BANK, V.U. Branch (For Admission in Head Quarter).
2. Separate Challan to be used for admission and renewal. 2. Separate Challan to be used for admission and renewal. 2. Separate Challan to be used for admission and renewal. 2. Separate Challan to be used for admission and renewal.
3. If paid by Draft the information is to be furnished. 3. If paid by Draft the information is to be furnished. 3. If paid by Draft the information is to be furnished. 3. If paid by Draft the information is to be furnished.
Study Centre will give receipt. Study Centre will give receipt. Study Centre will give receipt. Study Centre will give receipt.
Part-I : To be retained by Bank/Study Centre Part-II : To be sent to the D.D.E., by Bank/Study Centre Part-III : To be kept for Finance Section (DDE) Part-IV : To be retained by the Applicant