Present Address House No/Street Village/Town/City Pin Code Post Office District State Country Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Central African Republic Chad Chile China Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria North Korea North Macedonia Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea South Sudan Spain Sri Lanka Sudan Suriname Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Yemen Zambia Zimbabwe

Name Of School

Board CBSE ISC ICSE NIOS WBCHSE OTHERS

Roll No. / Unique ID

Registration No.

Note: Put the marks of English as compulsory and the marks of other subjects in decending order. The marks of EVS will not be considered.

Sl No.	Subject ( Higher Secondary/ Equivalent)	Full Marks	Marks Obtained
1 (English)*
2 (Best Of Subject 1)*
3 (Best Of Subject 2)*
4 (Best Of Subject 3)*
5
6

Total(English & Best of 3):

Preference 1* Select English Major Geography Major History Major Psychology Major Political Science Major Sociology Major Education Major Botany Major Computer Science Major Microbiology Major Zoology Major BCA Major Physics Major Mathematics Major B.Com Major (Rajganj Campus) B.Com Major (Siliguri Campus) BBA Major (Siliguri Campus)

Preference 2* Select English Major Geography Major History Major Psychology Major Political Science Major Sociology Major Education Major Botany Major Computer Science Major Microbiology Major Zoology Major BCA Major Physics Major Mathematics Major B.Com Major (Rajganj Campus) B.Com Major (Siliguri Campus) BBA Major (Siliguri Campus)

Preference 3* Select English Major Geography Major History Major Psychology Major Political Science Major Sociology Major Education Major Botany Major Computer Science Major Microbiology Major Zoology Major BCA Major Physics Major Mathematics Major B.Com Major (Rajganj Campus) B.Com Major (Siliguri Campus) BBA Major (Siliguri Campus)

Note: The minor course paper will be offered at the time of final admission.

Declaration
I hereby declare that the above statements are correct and I am fully aware that any misrepresentation will make me liable to disciplinary action taken by the principal of the college and other appropriate authorities.The terms and conditions of admission, and the rules and regulations of the college have been clearly explained to me and I have fully understood them, and all my documents are authentic. I freely agree to abide by these and other such rules and regulations as may be formulated/amended by the college authorities from time to time.

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