St. Xavier's College (Autonomous), Burdwan

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

Truth • Justice

ADMISSION FORM

FOR OFFICE USE ONLY

COURSE {{ $courseName }}

COLLEGE ROLL NO.

STREAM {{ $application->subject ?? '' }}

COMBINATION SUBJECTS (1)

COMBINATION SUBJECTS (2)

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STUDENT'S NAME {{ $application->applicant_name }}

DATE OF BIRTH {{ $dobDay }} / {{ $dobMonth }} / {{ $dobYear }}

RELIGION {{ $application->religion }}

COMMUNITY

OBC

GENERAL

WHATSAPP NO : {{ $admission->whatsapp_no ?? $application->contact_no }}

AADHAR NO: {{ $admission->aadhaar_no ?? ($application->aadhaar_number ?? '') }}

SUBJECT COMBINATION IN MADHYAMIK/STD. (X) {{ $line1 }}

SUBJECT COMBINATION LINE 2 {{ $line2 }}

PERCENTAGE OF MADHYAMIK/STD. (X): {{ $admission->percentage_of_madhyamik ?? '' }} %

FATHER'S NAME {{ $application->father_name }}

OCCUPATION {{ $admission->father_occupation ?? ($application->father_profession ?? '') }}

Mobile No. {{ $admission->father_mobile ?? '' }}

MOTHER'S NAME {{ $application->mother_name }}

OCCUPATION {{ $admission->mother_occupation ?? '' }}

Mobile No. {{ $admission->mother_mobile ?? '' }}

GUARDIAN'S NAME {{ $admission->guardian_name ?? '' }}

(In case of out station students / if parents are not alive)

ANNUAL FAMILY INCOME (FROM ALL SOURCES) {{ $formattedIncome }}

ADDRESS FOR CORRESPONDENCE {{ $admission->corr_address ?? $application->address }}

P.O. {{ $admission->corr_po ?? '' }}

District {{ $admission->corr_district ?? '' }}

Pin {{ $admission->corr_pin ?? ($application->pincode ?? '') }}

MOBILE {{ $application->contact_no }}

PERMANENT ADDRESS {{ $admission->permanent_address ?? '' }}

District {{ $admission->permanent_district ?? '' }}

Pin {{ $admission->permanent_pin ?? '' }}

Email id of Guardian: {{ $student->guardian_email ?? ($application->email ?? '') }}

CURRICULAR ACTIVITIES (IF ANY)

(1) SPORTS & GAMES {{ $admission->sports_games ?? '' }}

(2) CO-CURRICULAR ACTIVITIES {{ $admission->co_curricular_activities ?? '' }}

(Singing/Acting/Dancing/Voice Over etc.)

ADMISSION RULES AND REGULATIONS OF ST. XAVIER'S COLLEGE (AUTONOMOUS), BURDWAN

According to U. Reg. 3 (UG) of Burdwan University, the regular attendance of 75% is compulsory for all the courses to be eligible for semester exams.
A student once enrolled for a course is expected to complete the same. However the student can withdraw or change the subject with the approval of the principal within a month of commencement of the course.
A student may not knowingly provide false information or misrepresentation to the college management for the verification and communication.
When Co-Curriculum Activities, Social Outreach, College Programmes, Department Exposure Programmes and other activities are organised by the department or the college, students have to take part in them without a fail.
Students are allowed to use Social Network for their personal communication only. The use of social media to harass, threaten, insult and defame individual student, group of students, staff and the college management is dealt seriously with a fine and suspension from the college.
Under the disciplinary action, the principal is empowered to fine, suspend or even expel a student from the college in the interest of the institution.
Please refer to the college Calendar for other rules and regulations of the College.

I agree to abide by all the conditions, rules and regulations of the College, including the terms of fee of the College.

DATE: {{ optional($admission)->created_at ? optional($admission)->created_at->format('d/m/Y') : now()->format('d/m/Y') }}

{{-- {{ $application->father_name }} --}}

FATHER'S SIGNATURE

{{-- {{ $application->mother_name }} --}}

MOTHER'S SIGNATURE

@php $sigDoc = $application->getDocumentByType('signature'); @endphp @if ($sigDoc && Storage::disk('public')->exists($sigDoc->file_path)) Student Signature

@else {{ $application->applicant_name }} @endif

STUDENT'S SIGNATURE

{{--

--}}

Verified By Principal