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RAIGANJ UNIVERSITY
P.O. RAIGANJ ,DIST. UTTAR DINAJPUR
PIN - 733134, WEST BENGAL INDIA
APPLICATION FORM FOR ADMISSION
Application Id: SESSION 2025-2026
RGU5223375163
Payment ID.
order_QtmS4kAy8f0ciZ
1. Personal Information:
Name: SOUMYA MUKHERJEE Date of Birth: 26/ April /1986
Gender: Male Place of Birth: Uttar latabari
Application: Ph.D. (Physics) Marital status: Married
Social category code: GENERAL (UR) Economic category: Non-BPL
Foreign Student?: No Nationality INDIAN
Religion: Hinduism Blood Group: O+
PH: No Mother Tongue: BENGALI
Kanyashree: No Kanyashree No.:
Cast Cert. No.: Type of application: PH.D. With Course Work (M. Phil.)
Have you studied at Raiganj University for the last year : No Migration Certificate: No
Whether NET Qualified: Yes Whether qualified JRF: No
SET qualified : No
GATE qualified : Yes
2. Permanent Address:
Address: C1,304, Prantik Housing Complex, Sonarpur Station Road, ,
R K Pally, South 24 Parganas, West Bengal (700150),
Police Station:
Mobile No: 8777086539 Land Phone: India
3. Communication Address:
(a) Address: C1,304, Prantik Housing Complex, Sonarpur Station Road,
R K Pally, South 24 Parganas, West Bengal (700150)
Mobile No: 7908403008, 8777086539 Land Phone: India
E-mail ID: [email protected]
4. Family Details:
Father's Name: Sanjay Mukherjee Mother's Name: Sumita Mukherjee
Occupation: Occupation:
Annual Family Income: Above 500000
5. Local Guardian Details:
Guardian Name: Sanjay Mukherjee Relation: Father
Occupation: Business Contact:
6. Employer Details: 1
WEST BENGAL EDUCATION SERVICE
Govt Job
ASSISTANT PROFESSOR IN PHYSICS
Teaching
6. Employer Details:
Sl No Name of Employer Experience Designation /Position Nature of Work
1 WEST BENGAL EDUCATION SERVICE Govt Job ASSISTANT PROFESSOR IN PHYSICS Teaching
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7. Academic Details:
Last College Attended Details:
Institute Name: JADAVPUR UNIVERSITY
Address: JADAVPUR, KOLKATA 700032
Country: INDIA State: WEST BENGAL
City: KOLKATA Pin Code: 700032
Medium of Instruction: ENGLISH
8. Entrance Exams Scores Details:
Entrance Exams CMAT MAT (AIMA) ATMA JEMAT CAT XAT
Scores
9. Educational Qualification:
Name of Examination Year Roll No. Division/ Grade Name of School/ College Name of Board/ University Total Total % of
Marks Secured marks
UNION ACADEMY KALCHINI West Bengal Board of Secondary
10th 2000 2131-0297 1ST 800 738 92.25
HIGH SCHOOL Education
UNION ACADEMY KALCHINI West Bengal Council of Higher
(10+2) th std. 2002 128111-0700 1ST 1000 893 89.3
HIGH SCHOOL Secondary Education
Graduation 2005 FBP/II/31 1ST JADAVPUR UNIVERSITY Jadavpur University, West Bengal 1200 839 69.92
Post Graduation 2007 2MP/II/09 1ST JADAVPUR UNIVERSITY Jadavpur University, West Bengal 1600 1341 83.81
Professional
M.Phil.
Coursework
DECLARATION:
I further undertake that the preference for the courses, domicile and the categories and others to which I belong as indicated by me in the online application form
shall be irrevocable.
Printed on : 16-07-2025 08:32 PM
(Signature of the candidate)
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University Copy (Receipt for Online Payment) Student Copy (Receipt for Online Payment)
Receipt - Admission 2025-2026 Receipt - Admission 2025-2026
Application No: RGU5223375163 Application No: RGU5223375163
Challan No: order_QtmS4kAy8f0ciZ Challan No: order_QtmS4kAy8f0ciZ
Order Date: 16-07-2025 08:31 PM Order Date: 16-07-2025 08:31 PM
Name: SOUMYA MUKHERJEE Name: SOUMYA MUKHERJEE
Email ID:
[email protected] Email ID:
[email protected] Category: GENERAL (UR) Category: GENERAL (UR)
DEPOSIT DETAILS (INR) DEPOSIT DETAILS (INR)
Sl. No. Particulars Amount (Rs.) Sl. No. Particulars Amount (Rs.)
1 Total Amount Rs.1000 1 Total Amount Rs.1000
Amount in Words : Rs. One Thousand only Amount in Words : Rs. One Thousand only
Depositor Signature Bank Acknowledgement Depositor Signature Bank Acknowledgement
Non refundable Non refundable
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