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Vivekananda Mission Mahavidyalaya
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PG ADMISSION APPLICATION FORM
P.G Course :
Select From List
BENGALI (PG)
HISTORY (PG)
PHILOSOPHY (PG)
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PERSONAL INFORMATION OF THE APPLICANT
First Name of Applicant
Middle Name
Last Name
Gender
MALE
FEMALE
TRANSGENDER
Nationality
First Generation Learner
Date of Birth
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Whether PWD
No
Yes
PWD Type
1 BLINDNESS
2 LOW-VISION
3 HEARING IMPAIRMENT
4 SPEECH AND LANGUAGE DISABILITY
5 LOCOMOTOR DISABILITY
6 MENTAL ILLNESS
7 SPECIFIC LEARNING DISABILITIES
8 CEREBRAL PALSY
9 AUTISM SPECTRUM DISORDER
10 MULTIPLE DISABILITIES INCLUDING DEAF BLINDNESS
11 LEPROSY CURED PERSONS
12 PARKINSONS DISEASE
13 DWARFISM
14 ACID ATTACK VICTIM
15 INTELLECTUAL DISABILITY
16 MUSCULAR DYSTROPHY
17 CHRONIC NEUROLOGICAL CONDITION
18 MULTIPLE SCLEROSIS
19 THALASSEMIA
20 HEMOPHILIA
21 SICKLE CELL DISEASE
Disability %
Whether EWS
NO
YES
Religion
Hinduism
Christian
Islam
Sikh
Jain
Minority
No
Yes
Blood Group
A+
A-
B+
B-
AB+
AB-
O+
O-
RARE
NOT DISCLOSED
Family Annual Income
APL/BPL
APL
BPL
Admission Category
General
SC
ST
OBC-A
OBC-B
EWS
General-PWD
SC-PWD
ST-PWD
OBC-A-PWD
OBC-B-PWD
Social Category
General
SC
ST
OBC-A
OBC-B
Mother Language
Nearest Railway Station
Sports
PARENTS INFORMATION
Father Name
Father Qualification
Father Occupation
Mother Name
Mother Qualification
Mother Occupation
Monthly Family Income
Guardian Name
Gurdian Contact No
PRESENT ADDERSS DETAILS OF THE APPLICANT
Village
PO
Police Station (PS)
Block
District
PIN
State
PERMANENT ADDERSS DETAILS OF THE APPLICANT
Village
PO
Police Station (PS)
Block
District
PIN
State
CONTACT DETAILS OF THE APPLICANT
Candidate Mobile No.
WhatsApp No
Aadhar No
Kanyashree ID
Email Id.
ACADEMIC INFORMATION
সমস্ত ক্ষেত্র বাধ্যতামূলক
Class 10th Percentage
Class 12th Percentage
UG University
UG Regn. No.
UG Subject
SELECT
BENGALI (H)
HISTORY (H)
PHILOSOPHY (H)
UG Regn Year
2020-2021
2021-2022
2022-2023
2023-2024
UG Passing Year
2023
2024
UG Curriculam
Institute/College Name
UNDER GRADUATE MARKS INFORMATION
SELECT
BENGALI (H)
HISTORY (H)
PHILOSOPHY (H)
Full Marks
Marks Obtained
Core 1
Core 2
Core 3
Core 4
Core 5
Core 6
Core 7
Sec 1
Core 8
Core 9
Core 10
Sec 2
Core 11
Core 12
DSC 1
DSC 2
Core 13
Core 14
DSC 3
DSC 4
% of Marks
(CGPA x 10)
দ্রষ্টব্য: জমা দেওয়া ফর্মের যে কোনও সংশোধনের জন্য অনুগ্রহ করে আপনার নাম, ফর্ম নম্বর এবং মোবাইল নম্বর এবং যা সংশোধন করতে হবে তা উদ্ধৃত করে 8910915010 নম্বরে হোয়াটসঅ্যাপ করুন বা formfilluphelp@gmail.com-এ মেল করুন, যা 24 ঘন্টার মধ্যে আপডেট করা হবে। ঘন্টার মধ্যে আপডেট করা হবে।
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FORM NUMBER :
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Date :
2024-10-10
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