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West Bengal University of Technology DDEC

(Application ID)
Application form for Registration
(B. Tech.-B. Pharm.-BHM)

The Registrar,
West Bengal University of Technology
BF-142, Saltlake, Sector-1 Affix recent passport size
photograph
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 2010-2011. Necessary particulars relating to myself, given
below, are true to the best of my knowledge.

Place:_______________ Signature of Applicant


Date: _______________ (Please Sign within the box)

Registration applied for : General Entry to 1st Semester


Roll No. (if Re-Admission / Branch Change):
Registration No. (if Re-Admission / Branch Change):
Session Year : 2010-2011 Degree : B. Tech.
Registration Against : WBJEEE Enrollment No: 330319 (CSC)

Name : Kiran Panchal


Rank & Category : (WBJEEE), 4375 (GEN)
College Name : Future Institute of Engineering and Management
Course : B.Tech. in Mechanical Engineering

Sex: MALE Category: GEN Physically Challenged: N Date of Birth: 9-10-1992


Nationality : Indian Religion : Hindu
Father's Name : Nanda Panchal
Mother's Name : Sumitra Panchal
Address1 : X-40/5 khaldhari road , kol-18
Address2 :
PIN-700018 Phone: 9231820182 Email:
Guardian's Name : Nanda Panchal
Address1 : X-40/5 khaldhari road , kol-18
Address2 :
PIN-700018

Name of School/College or University of which he/she was a student prior to this admission:-
akra shaktigarh rabindra vidyapith
If that College is affiliated to this University, Please mention the student's Registration no. and year :-
Registration No: Year:
Migrated from another University:
Letter Number: Letter Dated (DD/MM/YYYY):

Particulars of 10+2 examinations passed.


(Attested copies of all documents should be attached)
Examination Year Board/Council Marks Aggregate(%) Class/Divn
H.s 2010 W.B.C.H.S.E Physics: 89.0 76.40 1st
Chemistry: 86.0
Mathematics: 94.0
English: 63.0

Submission Date: 2010-09-21 18:42:15 Photo Uploaded: N Page-1/2


Student Name : Kiran Panchal (Application ID : DDEC)

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. Full Signature of Guardian with date

Checked and Forwarded by

__________________________________________
Signature of Director / Principal / Teacher-in-charge Name of College/Institution ____________________
__________________________________________
College Code _______________________________

Seal ________________________________ Date: ______________ Place __________________

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 duty-
bound 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 Declaration and Undertaking by the Guardian

I do hereby declare that I am fully aware of the I do hereby declare that I am fully aware of the
above noted Approach of West Bengal above noted Approach of West Bengal University of
University of Technology towards ragging and Technology towards ragging and the statutory
the statutory punishment to which a student shall punishment to which a student shall be liable if
be liable if found guilty of ragging and hereby found guilty of ragging and hereby undertake that
undertake that I shall neither indulge any ragging my ward shall neither indulge in any kind of ragging
activities nor shall take part in or subject anyone activities nor shall take part in or subject anyone to
to ragging. ragging.

.................................................. ................................................
Full Signature of the Candidate Full Signature of the Guardian
Date: ......................................... Date: .......................................

Submission Date: 2010-09-21 18:42:15 Page-2/2

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