Centre for Agri-Management
Department of Business Administration, Utkal University
Vani Vihar Bhubaneswar-751004
Application No. : 2022507
Personal Details
Full Name:
Photo:
Signature:
Whats App No :
Date of Birth:
bijoykumarbhadra@gmail.com 8240754608
8240754608
11/11/2000
Gender :
Category :
Nationality :
Religion :
Male
GEN
India
HINDUISM
Blood group :
Mother tongue :
Aadhaar No.
Fathers Name :
RAJENDRA
PRASAD
BHADRA
BIJOY KUMAR BHADRA
E mail id :
Mobile no :
B+
Odia
493912475529
Mothers Name :
Parents Mobile No. :
Tel no with std code :
SUJATA BHADRA
9330961550
Emergency Contact
Full Name:
Mrs SUJATA BHADRA
Relationship with you in
case of emergency contact :
MOTHER
Emergency Contact :
9836106022
Address for Correspondence
Present Address :
Permanent Address :
Address 1:B/38/H/5 D.C.DEY ROAD
Address 2:
City:KOLKATA
State:WEST BENGAL
Country:India
PIN Code:700015
Address 1:B/38/H/5 D.C.DEY ROAD
Address 2:
City:KOLKATA
State:WEST BENGAL
Country:India
PIN Code:700015
Educational Qualification - Matriculation/Secondary School Examination
Board/University Name :
Name of the
School/Institute :
10th Roll No.
Year of passing :
CBSE
KENDRIYA
VIDYALAYA NO. 2
SALT LAKE
6135904
2016
Total Marks :
Marks Secured :
% of Marks :
Division :
500
390
78%
1st
Educational Qualification - +2, Higher Secondary, Equivalent
Board/University Name :
Name of the
College/Institute :
Stream :Science
+2 Roll No.
CBSE
KENDRIYA
VIDYALAYA NO. 2
SALT LAKE
Division : 1st
6635221
Year of passing :
Total Marks :
Marks Secured :
% of Marks :
2018
500
324
65%
Stream : Other...
Educational Qualification - Graduation
Board/University Name :
Name of the
College/Institute :
Stream :
UGC
THE NEOTIA
UNIVERSITY
B.Sc.(Ag.)
Year of passing :
Result Declared :
Total Marks :
Marks Secured :
No
% of Marks :
Division :
Distinction :
Work Experience
Do you have any Work Experience:
Entrance Exam Name :
No
Entrance Details
Entrance Exam Appeared :
Entrance Exam Name : Other Entrance Exam
Entrance Roll No :
Entrance Exam
Score :
No
+10th Marksheets:
+2 Marksheets:
Graduation
Marksheets:
Category Certificate:
Entrance ScoreCard:
Experience Certificate:
DECLARATION BY THE CANDIDATE: I hereby declare that all the particulars stated in this
application are true to the best of my knowledge and belief. I have read the Information Brochure and I
shall abide by the terms and conditions therein. In the event of suppression or distortion of any fact like
suppressing the category or educational qualifications or nationality, etc. made in my application form, I
understand that I will be denied the opportunity to admission and if already admitted, my
admission/degree acquired is liable for cancellation. I understand that the decision of the Institution
regarding my admission is final and I shall abide by the decision. Further, if admitted, I promise to abide
by the rules and norms of discipline of the Institution.
Signature of the Candidate
Note : Print this application form to retain a copy for future reference.
Application Date : Thursday,June,30,2022-18:16