Students Data Collection Form
Bangabasi Evening College
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Higher Education Department
1. What is Your Name? *
1.A What is Your First Name?
1.B What is your Middle Name?
1.C What is Last Name
2. What is Your Date of Birth? *
MM
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DD
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YYYY
3.  What is Your Gender? *
4. What is Your Fathers Name? *
5. What is your Mothers Name? *
6. What is your Social Category? *
6. A  In which social category you were admitted? *
7. What is Your Religion *
8. What is your Nationality *
9. What is Your Aadhar No (12 Digit)? *
10. What is Your Blood Group? *
11. What is your Annual Family income ? *
12. Do you have any disability? *
13. What is your email id? *
14. What is your Mobile No (Ten Digit)? *
15. You are studying in which Program Level? *
16. What is your Program Category *
17. What is your Course/ Stream /Subject Name *
17. A Not Available in 17
18. What is your medium? *
19. What is your session of admission? *
20. What was the Last qualifying exam you have passed (for UG HS, for PG Graduation)? *
21. What Percentage or Grade you have obtained in the last qualifying exam? *
22. What is the premises no. street, location your current/present address? *
23. Which state you belong (current/present address)? *
24. What is your district (current/present address)? *
25. What is your Post Office (current/present address)? *
26. What is your Police Station (current/present address)? *
27. What is your PIN Code 6 digit (current/present address)? *
28. What is your Municipality/Municipal Corporation/Block (current/present address)? *
29. What is the premises no. street, location your Permanent address? *
30. Which state you belong (Permanent address)? *
31. What is your district (Permanent address)? *
32. What is your Post Office (Permanent address)? *
33. What is your Police Station (Permanent address)? *
34. What is your PIN Code 6 digit (Permanent address)? *
35. What is your Municipality/Municipal Corporation/Block (Permanent address)? *
36. What is the name of your Guardian? *
37. What is the Guardian Contact No.? *
38. What is Guardian Email? *
39. What is your relation with the Guardian? *
40. What is your Calcutta University Registration No. *
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