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    Berhampur University: Application For Admission Into M.A/M.Sc. in Mathematics Academic Session 2019-20

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    Subham Priyadarshi
    Priyadarsini Moharana, an unmarried Indian female from Odisha, applied for admission to the M.A./M.Sc. program in Mathematics at Berhampur University for the 2019-20 academic year. She completed her B.Sc. in Mathematics with Honors from Utkal University in 2019 and scored 443/600 in HSC and 387/600 in 12th standard. She is currently residing 250 km from Berhampur University and is seeking hostel accommodation. She paid the application fee of 600 rupees via an online transaction on June 10, 2019 and signed the application declaring the information provided is true.

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    Berhampur University: Application For Admission Into M.A/M.Sc. in Mathematics Academic Session 2019-20

    Uploaded by

    Subham Priyadarshi
    140 views2 pages
    Priyadarsini Moharana, an unmarried Indian female from Odisha, applied for admission to the M.A./M.Sc. program in Mathematics at Berhampur University for the 2019-20 academic year. She completed her B.Sc. in Mathematics with Honors from Utkal University in 2019 and scored 443/600 in HSC and 387/600 in 12th standard. She is currently residing 250 km from Berhampur University and is seeking hostel accommodation. She paid the application fee of 600 rupees via an online transaction on June 10, 2019 and signed the application declaring the information provided is true.

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    Priyadarsini Moharana, an unmarried Indian female from Odisha, applied for admission to the M.A./M.Sc. program in Mathematics at Berhampur University for the 2019-20 academic year. She completed her B.Sc. in Mathematics with Honors from Utkal University in 2019 and scored 443/600 in HSC and 387/600 in 12th standard. She is currently residing 250 km from Berhampur University and is seeking hostel accommodation. She paid the application fee of 600 rupees via an online transaction on June 10, 2019 and signed the application declaring the information provided is true.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    140 views2 pages

    Berhampur University: Application For Admission Into M.A/M.Sc. in Mathematics Academic Session 2019-20

    Uploaded by

    Subham Priyadarshi
    Priyadarsini Moharana, an unmarried Indian female from Odisha, applied for admission to the M.A./M.Sc. program in Mathematics at Berhampur University for the 2019-20 academic year. She completed her B.Sc. in Mathematics with Honors from Utkal University in 2019 and scored 443/600 in HSC and 387/600 in 12th standard. She is currently residing 250 km from Berhampur University and is seeking hostel accommodation. She paid the application fee of 600 rupees via an online transaction on June 10, 2019 and signed the application declaring the information provided is true.

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    Application No : MAT2019_BAM2019000229 Downloaded on : 10-06-2019 09:06 PM

    BERHAMPUR UNIVERSITY
    APPLICATION FOR ADMISSION INTO

    M.A/M.Sc. in Mathematics

    ACADEMIC SESSION 2019-20


    1. Applicant's Information :
    Applicant Name (As in HSC Certificate) : PRIYADARSINI MOHARANA

    Gender : Female

    Nationality : Indian

    Are you a Kashmiri Migrant? : NO

    Date of Birth : 07-06-1999 (Seventh June Nineteen Ninetynine)

    Aadhaar Number : 939027467622

    Mobile No : 7077916492

    Email Id : pmpriya221@gmail.com

    Marital Status : Unmarried

    Father's/Guardian's Name : PADMANAV MAHARANA

    Mother's Name : USHARANI MAHARANA

    2.(a) Permanent Address :


    Plot/House No/At/Apartment No. : QR NO 2R 3/8

    Locality/Street Name : Unit 9 flat

    Post : Bhoinagar

    District : Khordha

    State : Odisha

    PIN : 751022

    Parent’s /Guardian’s Telephone / Mob. No : 9861016492

    (b) Residential Address :


    Plot/House No/At/Apartment No. : QR NO 2R 3/8

    Locality/Street Name : Unit 9 flat

    Post : Bhoinagar

    District : Khordha

    State : Odisha

    PIN : 751022

    3. Admission is Claimed Under Any Reserve Quota : No


    Reserved Quota: : General
    Other Category: :
    Disability Type: :
    Disability Percentage: :
    Whether Assistance Required? :
    4. Qualifying Degree:

    Degree : B.Sc Honors/ Pass : Honours

    Status : Appeared Honours Subject : Mathematics

    University : Utkal University University Roll No :

    University Reg No : Division :

    Subjects (Incl. Hons.) : 1. Mathematics 2. Physics


    Year of Passing : 2019
    3. Chemistry 4.

    Total mark / CGPA secured:

    Maximum Marks / CGPA : 2600

    Distinction :

    5.Educational Qualification

    Name of the Board /Council/ Mark


    YOP Division Maximum Marks % of Marks
    Examination University Secured

    HSC/10th HSE 2014 1st 443.00 600 73.83

    12th/+2 CHSE 2016 1st 387.00 600 64.50

    6. Whether Interested to Apply for Hostel Accommodation : Yes

    7. Distance between Berhampur University and your present address : 250 KM

    8. Payment Refund Information :


    Account Holder Name :Debashis Moharana

    Account Number : 00000037209638727

    Bank Name : State Bank of india

    IFSC Code : SBIN0007891

    9. Payment Details :
    Mode : ONLINE Amount : 600.00 Transaction Id : 132994389 Date : 10-06-2019

    DECLARATION
    (1) I declare that the particulars furnished in this form are true to the best of my knowledge and belief and as per my certificates and
    valid official documents. I further declare that in case any of the above information is found to be incorrect at any time, I shall be liable
    to forfeit my seat and to such penal action as the University may deem appropriate.
    (2) I undertake to abide by the rules of the P.G. Council and P.G. Hostels, framed by the Berhampur University and if at any time, in
    any instance of breach of these rules, indiscipline, disobedience or misconduct or involvement in ragging is found against me, my
    name shall be struck off from the rolls of the University.
    (3) I have understood the various provisions and rules of eligibility and admission to various P.G. Departments of Berhampur University
    as mentioned in the Prospectus along with the application form and I undertake to abide by any decision taken by the University
    authorities in regard to my eligibility and admission into P.G. Departments.

    Date: 10-06-2019

    Scanned Signature of the Applicant


    Full Signature of the Applicant

    Please send the signed copy of this form to Mathematics, by REGD/SPEED POST ONLY so as to reach on or before
    16.07.2019 or within 15 days of publication of +3 final results of Berhampur University whichever is earlier.

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