St. Xavier's College (Autonomous), Burdwan

ST. XAVIER'S ROAD • P.O. SRIPALLI • Dt. PURBA BARDHAMAN • W.B. 713103

Truth • Justice

Academic Session 2026–27

APPLICATION FORM – U.G. COURSE

Personal Information

Payment

Document Upload

Instructions: Fill in all fields marked with * carefully. Use BLOCK LETTERS for your name, father's name and mother's name. Ensure details match your mark sheet exactly.

Select your category, course and subject carefully — changes are not permitted after submission.
Enter all subjects from your H.S. / Equivalent mark sheet in the table below.

Course & Category Details

Category *

General SC ST OBC Catholic

Course *

Subject / Honours *

Personal Details

Gender *

Male Female

1. Name of the Applicant (In Block Letters) *

2. Father's Name *

3. Mother's Name *

4. Date of Birth *

5. Contact No. *

9. E-mail ID *

6. Differently Abled *

No Yes

7. Nationality *

8. Religion *

10. Address for Correspondence *

PIN Code *

Academic Details

11. Year of Passing H.S. / Equiv. Exam *

12. Name of the Board / Council *

13. Name of Previous Institution *

Address of Previous Institution

H.S. / Equiv. Registration No.

Unique ID / Roll No.

Subjects and Marks in H.S. / Equiv. Exam

Note:

W.B.C.H.S.E. students: Language subjects + Best of 3. Physical Education & Environmental Science may be considered if compulsory elective.
Other Boards: Best of 4 subjects. Physical Education & Environmental Science may be considered if compulsory elective.
Enter marks exactly as printed in your mark sheet.

#	Subject	Full Marks	Marks Obtained	Remove
1
2
3
4
5
Aggregate
Percentage (%)

I hereby declare that all information provided above is true and correct to the best of my knowledge. I understand that any false information may result in cancellation of my admission.

Resume Existing Application