West Bengal University of Technology Application Form For Registration

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West Bengal University of Technology Application form for Registration

(B. Tech.-B. Pharm.-B. Arch.)

MAMB
(Application ID)

The Registrar, West Bengal University of Technology BF-142, Saltlake, Sector-1 Kolkata-700064, West Bengal
Sir, I hereby apply for registration as a student of West Bengal University of Technology. A sum of Rs. 400/- is remitted herewith as Registration Fee for the academic session 2012-2013. Necessary particulars relating to myself, given below, are true to the best of my knowledge. Place:_______________ Date: _______________ Signature of Applicant (Please Sign within the box)

Affix recent passport size photograph

Registration applied for : General Entry to 1st Semester Roll No. (if Re-Admission / Branch Change): Registration No. (if Re-Admission / Branch Change): Session Year : 2012-2013 Degree : B. Tech. Registration Against : WBJEEE Enrollment No: 3810050518 Name : Sudip Kumar Pathak Rank & Category : (WBJEEE), 16395 (GEN) College Name : JIS College of Engineering Course : B.Tech. in Electronics & Communication Engineering Applying for concession : NA

(TFW)

Sex: MALE Category: GEN Physically Challenged: N Nationality : Indian Religion : Hindu Father's Name : Sisir Kr Pathak Mother's Name : Suvra Pathak Address : 7, Seth Bagan Place, Dum Dum Junction, Kolkata PIN-700030 Phone: 9433974999 Email: [email protected] Guardian's Name : Sisir Kr Pathak Address1 : 7, Seth Bagan Place, Dum Dum Junction, Kolkata Address2 : PIN-700030

Date of Birth: 9-2-1994

Name of School/College or University of which he/she was a student prior to this admission:Hindu School

Particulars of 10+2 examinations passed.


(Attested copies of all documents should be attached) Examination Higher Secondary Examination Year 2012 Board/Council W.B.C.H.S.E Marks Physics: 73.0 Chemistry: 76.0 Mathematics: 66.0 English: 72.0 Aggr(%) 77.20 Class/Divn IST

Submission Date: 2012-11-01 12:55:24

Photo Uploaded: Y

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Student Name : Sudip Kumar Pathak (Application ID : MAMB) Name of College/Institution where you have been admitted :_________________________________________________________________________________________ The particulars mentioned in page 1 of registration form are true to the best of my knowledge. I shall abide by the rules & regulations of the West Bengal University of Technology. _________________________________________ Full Signature of student with date. Checked and Forwarded by __________________________________________ Signature of Director / Principal / Teacher-in-charge Name of College/Institution ____________________ __________________________________________ College Code _______________________________ Date: ______________ Place __________________ _________________________________________ Full Signature of Guardian with date

Seal ________________________________

West Bengal University of Technology


APPROACH OF WEST BENGAL UNIVERSITY OF TECHNOLOGY TOWARDS RAGGING
West Bengal University of Technology has accepted the guidelines issued by the Hon'ble Supreme Court in connection with judgement in Civil Writ Petition No. 656 of 1998 filed by Vishwa Jagriti Mission Vs. Central Government and Others. The University has also accepted the West Bengal Prohibition of Ragging in Educational Institutions Act. 2000 (W.B. Act XIII of 2000) which, inter alia, contained the following provisions (for detail,' The Calcutta Gazette' Extraordinary, published by Authority on Monday, May 29,2000 may be seen): 1."Ragging" means the doing of any act which cause, or is likely to cause any physical, psychological or physiological harm or apprehension or shame or embarrassment to a student, and includes(a) testing or abusing of playing Practical joke on, or causing hurt to any student or (b) asking any student to do any act, or perform any thing, which he/she would not, in the ordinary course, be willing to do or perform. 2.Provision of Ragging (a) Ragging within an educational institution is hereby prohibited. (b) No person shall participate in, abet, or propagate, ragging in any educational institution. 3.Penalty for Ragging (a) Expulsion from the educational Institution, if found guilty on enquiry by the institution against a complaint lodged by any other student. (b) Imprisonment of either description upto two years or fine upto five thousand rupees or both. (c) Any student convicted under 3 (b) shall be dismissed from the educational institution in which he/she has been prosecuting his/her studies for the time being, and shall not be readmitted to that educational institution. The University has further accepted in principle that each and every student of the University shall be dutybound during the entire period of studentship with the University to immediately report to the authority any ragging is noticed either in University hostel or in University campus. Declaration and Undertaking by the Candidate I do hereby declare that I am fully aware of the above noted Approach of West Bengal University of Technology towards ragging and the statutory punishment to which a student shall be liable if found guilty of ragging and hereby undertake that I shall neither indulge any ragging activities nor shall take part in or subject anyone to ragging. Declaration and Undertaking by the Guardian I do hereby declare that I am fully aware of the above noted Approach of West Bengal University of Technology towards ragging and the statutory punishment to which a student shall be liable if found guilty of ragging and hereby undertake that my ward shall neither indulge in any kind of ragging activities nor shall take part in or subject anyone to ragging.

.................................................. Full Signature of the Candidate Date: ......................................... Submission Date: 2012-11-01 12:55:24

................................................ Full Signature of the Guardian Date: ....................................... Page-2/2

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