MIRIK COLLEGE
Affiliated to Univesity of North Bengal
Application Form
Session 2025 - 26
Personal Details
Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Please Select
Male
Female
Category
*
Please Select
SC
ST
OBC - A
OBC - B
Unreserved
PwD
*
Please Select
Yes
No
PwD Type
*
Whether BPL
*
Please Select
Yes
No
Religion
*
Please Select
Hinduism
Buddhism
Christianity
Islam
Others
Identity Proof
*
Please Select
Aadhar Card
Voter Id
Pan Card
Identity Proof Number
*
Mother Tongue
*
Blood Group
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Nationality
*
Please Select
Indian
Marial Status
*
Please Select
Married
Unmarried
Bank Account Number
*
Bank IFSC Code
*
Bank Name and Branch
*
Bank A/C Holder's Name
*
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Address Details
Address
*
Country
*
State
*
District
*
Postal Code
*
Post Office
*
Police Station
*
City/Village
*
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Family Information
Father Name
*
First Name
Middle Name
Last Name
Father's Qualification
*
Father's Mobile Number
*
Please enter a valid phone number.
Father's Occupation
*
Annual Income
*
Mother's Name
*
First Name
Middle Name
Last Name
Mother's Qualification
*
Mother's Mobile Number
*
Please enter a valid phone number.
Mother's Occupation
*
Guardian Name
*
First Name
Middle Name
Last Name
Relationship with Candidate
*
Guardian Mobile Number
*
Please enter a valid phone number.
Guardian Occupation
*
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Academic Information
Class (X)
Board Name
*
Registration Number
*
Roll Number
*
Medium of Instruction
*
Year of Passing
*
Enter Class - X Marks
*
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Academic Information
Class (XII)
Board Name
*
Registration Number
*
Roll Number
*
Medium of Instruction
*
Year of Passing
*
Please Select
2025
2024
2023
Enter Class - XII Marks
*
Merit Index (%)
*
For Honous(Marks Obtained in SUBJECT opted + Marks Obtained in English + Best Marks Obtained in 2 other Subjects.)/4 Excluding ENVS (Eg. 80+75+76+82=313/4= 78.25%) For General (Marks Obtained in English + Best Marks Obtained in 3 other Subjects.)/4 Excluding ENVS (Eg. 80+75+76+82=313/4= 78.25%)
Course Applied For
*
Please Select
4 Year B.A (H./H.&R.) (Honours)
4Year B.A. Multidisciplinary Course (General)
The Students Cannot Select Minor Subjects Same as Major Subject. (For Honours)
4 Year B.A (H./H.&R.) (Honours)
*
4Year B.A. Multidisciplinary Course (General)
*
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Document Upload
Photo
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Signature
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Class - X Marks Sheet
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Class - XII Marks Sheet
*
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Age Proof
*
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Identity Proof
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Caste/Tribe Certificate
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Declaration
I hereby declare that the information provided by me in this application is true and correct to the best of my knowledge. I understand that any false information or misrepresentation may lead to cancellation of my admission at any stage. I agree to abide by all rules and regulations of Mirik College.
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