FOR CASH OFFICE USE ONLY Received Rs. .............................................Receipt No................................. Date .............................. ..... Receiving official cash section with Seal General SC ST OBC Permanently Disabled Please Tick Mark (3) Where Applicable 1. OLD / NEW SYLLABUS 2. REGULAR / Suplimentary 3. PLEASE TICK MARK (3 3 3 3 3) WHERE APPLICABLE EXAM FEES RS. SUBJECTS OF EXAMINATION (to be filled in by the candidate) Theoritical Paper Practicals / Sessionals ( In block letters & according to Registration Certificate) Stamp Size Photo Stamp Size Photo Yours obediently, Full Signature of the candidate. JADAVPUR UNIVERSITY EXAMINATION APPLICATION FORM ( t o be filled in by the applicant) ........................................................Examination 20............... Examination Roll No...................................................................... (EXAMINATION ROLL NUMBER TO BE GIVEN BY THE OFFICE) To The Controller of Examinations, Jadavpur University, Kolkata - 700 032. Sir, I request your permission to appear in the undermentioned papers of the above-refer red Examination of the University to be held in ................................................. The requisite fee of Rs........................... ................(Rupees............... ................................................... ......) only is being submitted alongwith. My brief particulars are furnished undern eath. Date.............................. 1. Name in full............ ..........................First...........................................Middle..............................................Surname Sex............... ...(male/female)........ ............................................ 2. Son/Daughter of ........................................................................ 3. Address for all Correspondence in future........... ............................... ............................................................................................... .............................................................................................. 4. Phone No. ......................................Mob. No. .......................... 5. Present class....................................Department....................... 6. Class Roll No................................................of.......................... 7. University Regn. No.................... ................... ..of................ ........ I solemnly declare that my admission to the said Examination is liable to cancellation in the event of omission of any information / submission of any incorrect information, on my part, in respect of this application, if detected at any stage. Yours obediently, Full Signature of the candidate. JADAVPUR UNIVERSITY Kolkata -700 032, India ADMIT CARD *ADMIT Sri/Smt. having Examination Roll No. and *Registration No. o f in the Examinati on Hall, for appearing in the *following subjects of the Examination Enclo : 1 ) Xerox Copy of Money Re ceipt (Mus t) 2) Xerox Copy o f Latest Grade Card of preceeding Semester (Must) EXMINATION ROLL NO. (to be filled in by off) MUSTER ROLL SECTION ONLY Verified M.R. Section with Seal TO BE VERIFIED BY THE MUSTER ROLL SECTION BEFORE SUBMISSION TO CASH SECTION