CIHM Prspectus Web

ApplicationForm

Ahmedabad/Gandhinagar

Fill in the Application form in BLOCKLETTERS

Form No.:Regd. No.:

1.CAMPUS APPLIED FOR:

2.COURSE APPLIED FOR:

3.APPLICANT’S PERSONALDETAILSName:

DOB:Gender : MaleFemale

Email id :

MobileNo.:Landline No.:

MaritalStatus:SingleMarriedBlood Group:

Category :GeneralSCSTOBCHandicapped Religion

4.ADDRESSFORCORRESPONDENCEAddress

City :State :

Pin No.:Phone No.:

5.FAMILYINFORMATIONName of Parent:

Father’s Occupation:Mother’sOccupation:

Family’s annual income PA (inRs.):1,00,0001,00,00-3,00,0003,00,000-10,00,00010,00,000 up

How would you finance studies atCIHM:SelfFamilyEmployerLoanOther Source

6.ACADEMICRECORD

Pleaseprovidelatestandauthenticdata.Marks/gradesshownheremustmatchwiththoseintheoriginalmarksheets.Percentagesshouldbecomputedbyincludingallsubjects/papers thatyouwroteinyourexams.Thosewhoareyettoappearforfinalexamshouldputaverage%ofmarksuptolastexamconducted.

Exam / Name ofInstitute / University/Board / DegreewithSpecialisation / MediumofStudy / Duration / % ofMarksscoredoverall
From(mm/yyyy) / To(mm/yyyy)
PostGraduation
CompletedContinuing
Graduation
Completed Continuing
H.S.C.
S.S.C.

7.WORKEXPERIENCE

Mention full-time paid employment after Graduation only. (Certificates to beattached)

Do not include training / project work / work done as an internal part of curricularrequirement

Name ofOrganization / Designation / Duration / Annual grosssalary(cost tocompany) / Reasons forleaivng
From(mm/yyyy) / To (mm/yyyy)

8.APPLICATION FORM PAYMENTDETAILS

(To be filled byApplicant)

Paid by:CashDDDDNo.:DD Date: Drawn on:Branch : City:

Demand Draft should be made in the favour of Cambay Institute of Hospitality Management payable atGandhinagar.

9.TERMS ANDCONDITIONS

Declaration

I certify that the information presented in this Application Form is accurate, complete and honestly presented. I understand and agree that any inaccurateinformation, misleadinginformationoromissionwillbeacauseforthewithdrawalofanyofferofadmissionorfordisciplinaryaction,dismissalorrevocationofdiploma,certificate,or anyawardifdiscoveredatalaterdate.IagreetohonortheCIHMCodeofEthicsinletterandspirit.Iunderstandthatalladmissionsarebasedstrictlyonmeritanddeclare thatIwillnotviolatetherulesagainstcanvassingdirectlyorindirectlytoseekadmissionintoCIHMand/ortoseekanyundue/specialfavoursoutsidetheframeworkof rulesinforcefromtimetotime.IherebyunderstandandacceptthatthedecisionofadmissionatCIHMCampusbytheAdmissionsCommitteeisfinalandbindingonme.

Iunderstandandagreethat

1.TheacademicandadministrativerulesandregulationsofCIHMasapplicablegivenintheprospectus,applicationmaterialandthosegivenoverleafincludingthelegal aspectsarebindingonme.

2.Iagreetoindemnify,defendandholdCIHMharmlessfromandagainstanyandallloss,damage,liabilityandexpensearisingoutofanythirdpartyclaim,actionsor proceedingsbymeorbymyagents.

3.Thecompletesetofacademicrules,tobegiventomeatthestartofeachTerm/year,willbebindingonme.

4.Theadmissiongivenfortheapplicantswhoareinthefinalyearofgraduationisprovisionalonly,subjecttotheircompletingthegraduationrequirementswith45%marks(orabove)aspertherulesfollowedbyrespectiveuniversityandsubmittingthedegreecertificateandmarkslisttoCIHM.

5.Thenumberofseatsperspecialisation,andinternalstructuringofvariousprogrammesandspecialisationswillbeatthesolediscretionoftheInstitute.

6.IdeclarethatIammedicallyfittostudyinCIHM.

7.CIHMreservestherighttochange/modifytheRegulationsfromtimetotimewithoutadvancenoticetothestudents.

8.IhavereadtheDisclosure,LegalAspectsandRegulationsandagreetoabidebythesame.

IherebycertifythatIhaveneadallthetermsandconditions,andfullyagreetoabidebythem.Theinformationprovidedbyme/mywardistrue,tothebestofmy knowledge. I authorize Cambay Institute of Hospitality Management and its affiliates / employees to use the Information contained here innay manner necessaryfor admissiontoitsprograms.

Date:

10.CHECK LIST (I have provided /enclosed)

Signature ofFather/GuardianSignature ofApplicant

IDProofThreecolorphotographwithformno.writtenatthebacksideofeachphotograph

MobileNumberLandlinetelephonenumber(ResidenceandOffice)

PermanentAddressCurrentMailingAddresswithPinNo.

EmailIDAttestedcopyofAcademicrecordofclass10thstd.,12thstd., Graduationandotherqualifications

DullyfilledandsignedtheDeclarationFormalongwithmyParents/Guardian.

11.FOR OFFICE USEONLY

DateofreceiptofApplicationReceiptNo.Acknowledgesenton DocumentsMissing

applicationverifiedbyDate Test

ScoresPrescribedFees

Selected/NotselectedDecisionnotifiedtoapplicanton

Website: Email:,

Contact. No. - 9714933353