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Student Data Capture Form for 1st , 3rd & 5th Semester Student, AY: 2022-23 of Sukanta Mahavidyalaya
* Indicates required question
Email
*
Your email
NAME OF THE STUDENT
*
Your answer
SEMESTER
*
SEMESTER 1
SEMESTER 3
SEMESTER 5
COURSE
*
B.A. HONOURS
B.SC
. HONOURS
B.A. PROGRAM
B.SC
. PROGRAM
BBA HONOURS
Roll Number
*
Your answer
FATHERS NAME
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Your answer
DATE OF BIRTH
*
MM
/
DD
/
YYYY
GURDIAN'S NAME
*
Your answer
MOTHERS NAME
Your answer
FATHER'S MOBILE NUMBER
*
Your answer
GURDIAN'S MOBILE NUMBER
*
Your answer
GENDER
*
MALE
FEMALE
SOCIAL CATEGORY
*
GENERAL
SC
ST
OBC-A
OBC-B
WHETHER APL/BPL ?
APL
BPL
Clear selection
RELIGION
*
HINDU
MUSLIM
CHRISTIAN
BUDDHIST
NATIONALITY
*
Indian
Other
AADHAAR NO.
*
Your answer
STUDENT MOBILE NO.
*
Your answer
WHETHER STUDENT IS DISABLE?
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YES
No
IF YES, WRITE PERCENTAGE OF DISABLILTY.
Your answer
PRESENT ADDRESS
*
Your answer
COUNTRY
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Your answer
STATE
*
Your answer
DISTRICT
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Your answer
POST OFFICE
*
Your answer
POLICE STATION
*
Your answer
PIN CODE
*
Your answer
SCHOLARSHIP RECEIVED SVMCM CHOOSE YES/NO
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YES
No
IF RECEIVED S.V.M.C.M SCHOLARSHIP WRITE ID NUMBER , YEAR & FRESH / RENEWAL
Your answer
SCHOLARSHIP RECEIVED K2 CHOOSE YES/NO
*
YES
No
IN PROCESS
IF RECEIVED K2 SCHOLARSHIP WRITE ID NUMBER & YEAR
Your answer
SCHOLARSHIP RECEIVED K3 CHOOSE YES/NO
*
YES
No
IN PROCESS
IF RECEIVED K3 SCHOLARSHIP WRITE ID NUMBER & YEAR
Your answer
SCHOLARSHIP RECEIVED AIKYASHREE CHOOSE YES/NO
*
YES
No
IN PROCESS
IF RECEIVED AIKYASHREE SCHOLARSHIP WRITE ID NUMBER & YEAR
Your answer
SCHOLARSHIP RECEIVED OASIS CHOOSE YES/NO
*
YES
No
IN PROCESS
IF RECEIVED OASIS SCHOLARSHIP WRITE ID NUMBER & YEAR
Your answer
OTHERS SCHOLARSHIP RECEIVED
*
uttarkanya scholarship
Jindal scholarship
INSTITUTION FREE SHIP
INSTITUTION AID FUND
Tea garden scholarship
None/None of the above
WHETHER APPLIED FOR STUDENT CREDIT CARD CHOOSE YES/NO
*
YES
NO
IF YES, MENTION YOUR CREDIT CARD NUMBER
YES
NO
Clear selection
A copy of your responses will be emailed to the address you provided.
Submit
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