ST. XAVIER'S COLLEGE [AUTONOMOUS]
30, MOTHER TERESA SARANI, KOLKATA - 700 016
MANDATE FORM FOR REFUND OF ADMISSION CANCELLATION
(FILL IN THE FOLLOWING INFORMATION IN CAPITAL LETTERS)
Student Name :
Department :
Select Department
ARTS & SCIENCE
ARTS [RAGHABPUR]
COMMERCE [MORNING]
COMMERCE [EVENING]
COMMERCE [RAGHABPUR]
DEPARTMENT OF BUSINESS ADMINISTRATION
POST GRADUATION IN SCIENCE [P.G.SC]
B.ED
POST GRADUATION IN COMMERCE [P.G.COM]
POST GRADUATION IN ARTS [P.G.ART]
POST GRADUATION IN ARTS [P.G.ART] [RAGHABPUR]
M.A. EDUCATION
Course :
Year of Admission :
Course Application Code :
Gender :
Select Gender
Male
Female
Mobile No. :
Email ID :
Reason for cancellation of admission :
Select Reason for cancellation
Admission in some other College / Institution
Transfer to another department in St. Xavier's College
Due to personal reason
Inadvertently taken admission
Some other reason
Bank Details
Name of the Account Holder :
Name of the Bank :
Name of the Branch :
Address of the Branch :
Account Number :
Type of Account (SB / CA / OD / Loan Account) :
Select Account Type
SB
CA
OD
Loan Account
IFS Code : (11 character)
I Understand that the refund will be done on the basis of the information provided above.