MSW BBA PGDBM MBA by ikevantrounk

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									                          A P P L I C A T I O N              F O R A D M I S S I O N F O R




                       PGDBM                     MBA                          MSW                   BBA
                                                                                                                              Space for Photograph



                                                                                                                               Affix yor recent passport size
                                                                                                                              photograph duly signed by the
                                                                                                                              candidate and attested by the
                                                                                                                            Co-ordinator at the learning Center




                                                                                                                                   Do not pin or staple
  Roll Number (For Office Use Only)

                                                                                                                        Read Instructions before filling the form

1. Name of the applicant as in the birth certificate or marks card of Standard X exam :                                 (Use Capital Letters only)


2. Father’s name:


3. Date of birth:                                       4. Sex:                                     5. Nationality:
                                                                  1. Male
                                                                  2. Female
  Date      Month      Year
6. Complete address for correspondence (Do not repeat name) Address of the student




          City:                                              State :                                                  Pin code :



7. STD code :                               Phone :                                         E-mail: :


8. Mode of Payment                                     DD / Cheque / Challan number:                         DD / Cheque Date

         Cash                 Cheque / DD


         Bank challan
                                                                                                             Date        Month        Year
9. Name of the Bank:                                                          Payable at Dharwad:




   For Office Use Only:
                                                      10. Important:
                                                       Paste your latest stamp size photo for ID card                                   Affix your recent
   Application No:                                     The photo should not extend outside box                                          stamp size photo
                                                       Candidate’s signature must be within box provided                                   for ID Card
                                                                                                                                        Photo should not
                                                                                                                                       extend outside the
                                                                                                                                          box provided.


                                                         Specimen signature of the candidate


   Cash / Cheque received by :                                Cash hand over to                                                       Authority Signature
                                                                    PGDBM            MBA           MSW            BBA

11. Applicant’s permanent address (Do not repeat name)




  City :                                                     Tel.                                                      Pin code :


12: Details of educational qualifications (From X Standard onwards)
               Name of the                    Year of
                                                                             School/College                                  University Board
              qualifying exam                 passing




                                                  DECLARATION BY THE APPLICANT
           I acknowledge to have fully read the prospectus of respective course and certify that I have understood all the provisions indicated therein.

           I hereby certify that all the particulars stated by me in this application are true to the best of my knowledge and belief. I understand that my
           admission is liable to be cancelled if I suppress or distort any information furnished in my application.

           I certify that I am qualified for the course as indicated in the Prospectus for admission and will produce the original Certificate (s) when
           asked for.

           I acknowledge and understand that MBA Degree is awarded by SMU (DE) & MSW Degree by Annamalai University (for PG students
           only)

           I understand that the University / Institution has the right to add/delete/change the syllabi, course structure, rules and regulations as and
           when required

            Place :
            Date :
                                                                                                                     Signature of the candidate


       For Office use only


       Ref by                                                                                                                        Approved

                                                                    Documents verified by                                     Chairman / Administrator




           Course             Sem          Fixed Fees               Reg / Sem Fees               Receipt No & Date                         Balance
                                                                                                   C                   F
                                I


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