Form printed on 21/11/2020 West Bengal State University Name BIKASH SHARMA Form Number 172316224 Application ID WBPG12016224 Subject Applied For Physics Honours Subject Physics Personal DetailsFather's/Guardian's Name LOKNATH SHARMA Mother Name DEVI SHARMA Fathers Qualification SECONDARY Mothers Qualification ILLITERATE Date of Birth 26/01/1999 Gender Male Caste General Email mr.bikash1234@gmail.com Mobile No. 8794546919 Physically Hadicapped No Disability Type N/A %Of Disability N/A Street / Village LAPALANG P.O. RYNJAH P.S. RYNJAH Pin 793006 State Meghalaya District EAST KHASI HILLS Street / Village LAPALANG P.O. RYNJAH P.S. RYNJAH Pin 793006 State Meghalaya District EAST KHASI HILLS Nationality INDIAN Madhyamik Registration Number Permanent Address - Present Address - University Last (Other)NORTH EASTERN HILL UNIVERSITY Passing Year 2020 G115052040101 Registration Number 17003160 Session 2017-2018 Academic Details Exam Passed Board or University Year Full Marks Marks Obtained % Of Marks Madhyamik or Equivalents CBSE 2015 500 409 81.80 H.S. (+2) or Equivalent CBSE 2017 500 368 73.60 B.A. / B.Sc. / B.Com. / Other HONOURS Full Marks Marks Obtained % Of Marks 600 419 69.83 General Subject I General Paper I 400 234 58.5 General Paper II 0 0 0 General Paper III 0 0 0 General Subject II General Paper I 400 251 62.75 General Paper II 0 0 0 General Paper III 0 0 0 800 485 60.625 Total of General Subjects I BIKASH SHARMA hereby declare that all the particulars stated by me in this Application Form are true and correct to the best of my knowledge and belief. I have read the relevant Information Brochure & Admission Schedule and advertisement for the course displayed on the University website/Printed Hard copy/Notice Board for Admission. I shall abide by the terms and conditions therein. It is entirely my responsibility,to prove my eligibility for admission to the programme to which i will be admitted and also, in respect of qualifications and entitlement for admission against reserved category, If claimed, to the satisfaction of the University. I have read the eleigibity criteria before applying if at the time of admission University found that my marks are not eligible for admission then it is liable to be cancelled. Further, in the event of suppression or distortion of any fact like category, educational qualification, nationality, etc. stated in Application Form. I understand that my admission if granted or degree acquired subsequently, is liable to be cancelled. I also understand that the decision of W.B.S.U regarding my admission will be final and I shall abide by the rules and Regulation of W.B.S.U from time to time. Place : ____________________ ____________________ Date : Signature of Guardian Signature of Candidate PAYMENT DETAILS: Application ID: WBPG12016224 Amount: Transaction ID: Date & Time: WBSU1SPL13472 0.00 15-11-2020 18:11:09 Documents Uploaded :1. 2. 3. 4. 5. 6. 7. 8. MP Marksheet HS Marksheet Reg Certificate UG Marksheet( 1 ) UG MARKSHEET( 2 ) UG MARKSHEET1( 3 ) UG MARKSHEET2( 4 ) UG MARKSHEET3( 5 ) Enclosures 1. Self attested true copies of marks-sheets of all the examinations passed ( 10th standard onwards ) 2. Proof of Date of Birth 3. SC/ST/OBC(A)/OBC(B)/PWD Certificate, if applicable 4. Family Income Certificate 5. Domicile Certificate, if applicable N.B.: All originals of the above with the prinout of the form duly signed by Guardian and Applicant to be shown at the time of submission of application form during the Counselling process.