Reg. No. Received by........................

Date....................................

Honours / Major.....................
Ramakrishna Mission Vidyamandira
(A Residential College) Fix a recent
P. O. BELUR MATH : DIST. HOWRAH-711202 photograph;
Tel: 2654-9181/9632 Web: www.vidyamandira.ac.in attestation not
necessary.
APPLICATION FORM FOR ADMISSION TO B.A./B.Sc. COURSE

1. (a) Name of the applicant : .........................................................................................................................

(in block letters)
(b) Father’s/Guardian’s Name :....................................................................................................................
(c) Address :..................................................................................................................................................
................................................................................................ Pin :........................................................

Telephone : ............................................................ Mobile : ................................................................

2. Date of birth : ................................................................................................................................................
(as recorded in the Admit Card of the Madhyamik/Equivalent Examination)
3. School from which passed the Higher Secondary (equivalent) Exam :
........................................................................................................................................................................
4. Subjects asked for at the Degree level :
Honours / Major Subject General Subjects Compulsory Languages
(1) English &
(2) Bengali / Alternative English

5. H.S./equivalent Marks
(excluding Enviromental Education/Studies) Year of passing
H.S./equivalent
Subject Theory Practical Total
1 Tick the Gen. SC
2 appropriate
ST PH
3 one :
4 [Appropriate certificate to be submitted
5 in case of SC/ST/PH candidate–Please
6 see Instruction No. (3) overleaf]
6. Aggregate of top Four subjects––out of 400
Aggregate in percentage (%)
Signature of Candidate
Date.........................................
P.T.O.

Reg. No. Ramakrishna Mission Vidyamandira

P. O. BELUR MATH : DIST. HOWRAH-711202 Fix a recent
photograph;
To be filled in Admit Card & Receipt attestation not
by candidate necessary.
]

Received the sum of Rs.100 (One hundred only) from

(Name) ...........................................................................................................................................
for applying for admission to ....................................... Honours/Major.
The Entrance Test is scheduled on ............................... June 2010.
at................................................................
Signature of Receiver with date
(Office)
 INSTRUCTIONS

1. Attested copies of the following documents should be provided along with the application:
(a) Marksheet of the Higher Secondary / Equivalent Examination
(b) SC/ST/PH Certificate (where applicable) from competent authority.
(c) Marksheet of the Madhyamik/Equivalent Examination [Only in case of Physics (Hons.) applicants]
2. Please note that it is the responsibility of the students to verify that the admission criterion for the
relevant Hons/Major subject is satisfied. A candidate may be disallowed from appearing for the admission
test if he does not satisfy any of the relevant norms.
3. Competent authorities to issue Scheduled Caste / Scheduled Tribe Certificate for admission to
colleges:(i) Additional District Magistrate, Sub-Divisional Officer, Executive Magistrate, Block
Development Officer within their respective jurisdiction, (ii) Member of Parliament, Member of
State Legislature, Member of Zilla Parishad, Councillor of Municipal Corporation, Commissioner
of Municipality within their respective jurisdiction.
4. The application form must be deposited at the Vidyamandira office and cannot be sent by post.
5. At the time of submission, Rs. 100 must be deposited along with this form.
6. While submitting form at the Admission Office, please verify that the college seal is put on the
photo attached in the ‘Admit Card & Receipt’.
7. The form is liable to be cancelled if the signature of the candidate is found to be forged/copied by
others.

FOR OFFICE USE ONLY

Recommended for admission to ............................................................................... Hons./Major.

Date: ............................... Signature of Principal / Vice-Principal

For further information please contact :

Telephone No. : 2654-9181/9632

Web : www.vidyamandira.ac.in