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MBA Application Form 2013

This document is an application form for admission to a two-year full-time MBA program from 2013-2015. It requests information such as the applicant's name, date of birth, nationality, gender, educational qualifications including exam results, work experience, extracurricular activities, and payment details. The completed form along with required documents must be submitted to the Dean of Research and Consultancy by the closing date of April 12, 2013 for consideration. Incomplete applications or those without supporting documents will be rejected.

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63 views2 pages

MBA Application Form 2013

This document is an application form for admission to a two-year full-time MBA program from 2013-2015. It requests information such as the applicant's name, date of birth, nationality, gender, educational qualifications including exam results, work experience, extracurricular activities, and payment details. The completed form along with required documents must be submitted to the Dean of Research and Consultancy by the closing date of April 12, 2013 for consideration. Incomplete applications or those without supporting documents will be rejected.

Uploaded by

friends_is
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Form No:

Affix a Recent colour passport size photograph

APPLICATION FORM (For Admission to Two years full time M.B.A. Programme 2013 2015) Registration Number: of year 2013 2015. Closing Date: 12nd April 2013, Friday SESSION (2013 2015) The application form properly filled and signed by the applicant together with attested copies of the pass certificates / mark sheet of all examinations passed including CAT / CMAT score card shall be send to the office of Dean (Research & Consultancy), PG & Research Section, National Institute of Technology, Durgapur. Mahatma Gandhi Avenue, Durgapur 713209, West Bengal so as to reach on or before closing date. Incomplete Application Form and Filled up Form without supporting Documents will be summarily rejected. 1. Name of the Applicant (In block Letters)

2. Date of Birth: 3. Nationality

4. Gender Male Female 5. State to which the applicant belong: 6. Name of Father / Guardian 7. Present Mailing Address:

(tick the appropriate box)

P I
8. Phone No / Mobile no: 9. Permanent Address:

N o

P I
10. E-Mail:

N o

11. Whether the Applicant belongs to Scheduled Cast / Scheduled Tribe / OBC / PH (Certificate from the competent authority, not below the rank of Tahsider should be attached in support of the statement). For OBC Candidates copy of certificate from a competent authority, not below the rank of Tahsildar, indicating the state regarding creamy layer, issued on or after 01/04/2012, is to be attached. General SC ST OBC PH (tick the appropriate box)

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12. Details of Educational Qualification: School/College Exam Passed (Board Year of passing University)

Subject Studied

Percentage

13. CAT Percentile Score: CMAT Rank: Score: 14. Details of Industrial Experience, If any ( Vocational Training will not be considered) Name of Employer From To Employed as Salary Drawn

15. Extra curricular activity: 16. Whether the applicant is receiving any stipend / financial assistant for his study, If so give details:

17. Details of attested photocopy of certificates / documents attached

a. b. c. d. e. f. g. h.
18. Paid the DD of Rs. 1050.00 (Rs. 450.00 for SC / ST) for downloaded form from Website Drawn in favour of National Institute of Technology Durgapur payable at State Bank of India, R.E College, Durgapur, bearing DD No: Dated: 19. Declaration by Applicant: I hereby declare that all the particulars stated above are correct. I understand the association whether active or passive with any unlawful organization is forbidden. If selected for admission. I promise to abide by the Rules and Regulation of the Institute.

Signature of Applicant (with date) FOR OFFICE USE Recommendation: Signature of HOD, DMS Page 2 of 2

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