DEPARTMENT OF MANAGEMENT STUDIES, Kumaun University Bhimtal Campus, Bhimtal – 263136(U.K.) APPLICATION FORM Two Year MBA (F/T) Programme
(*Please read the “Instructions for the Applicants” carefully before filling-up the form)
Roll No. …………….
Affix a recent passport size photograph duly signed(To be assigned by the Office)
1. Name …………………………………………………
2. Father’s Name …………………………………………………
3. Mother’s Name …………………………………………………
4. Date of Birth
Day Month Year
5. Sex Male Female
6. (a) Category :GEN SC ST OBC
(b) Sub–Category : AF FF W H
7. State of Domicile :Uttarakhand Other State
8. Address for Correspondence ………………………………………………………………………….…..
…………………………………………………………………………………………………………….
…………………………………………………………………………………………………………….
Phone No. with STD Code …………………………………... Mobile No. …….………………………
E-mail ………………………………………………………...Blood Group ………….……………….
9. (a) Qualifying Examination …………………………..………Passed/Appearing……………………….
(b) Year of Passing ………………………………...... Percentage ………………………………
(c ) University/College……………………………………………………………………………………..
10. MAT /CMAT/CAT details
(a) Month & Year of appearing ……………………………… Roll No. ………………………………
(b) Test Center with Code ……………………….. MAT/CMAT/CAT Score ………………..………
11. Whether any discontinuity in education after qualifying examination till date: Yes/ No
Gap period (session) Reason
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12. Hostel Requested YesNo
DECLARATION
I hereby declare that all the statements made in this application are true, complete and correct to the best of my knowledge and belief. I have checked the eligibility requirements for admission to MBA Programme of this Department / University. I fulfill/ shall fulfill all the conditions of eligibility. In the event of any information being found false or incorrect or any ineligibility being detected before or after the Entrance Examination/Group Discussion/ Personal Interview my candidature is liable to be cancelled and legal action may be initiated against me.
I undertake to follow and abide by the rules,guidelines and procedures adopted for admission.
Place: (Signature of the Applicant)
Date : (Signature of the Parent/Guardian)
………………………………………………………………………………………………………
FOR OFFICE USE ONLY
WITHDRAWAL BY THE CANDIDATE
I am not interested in the seat offered to me and I hereby withdraw my candidature. I shall not have any claim for admission to MBA programme of this Department hereafter.
Date: …………………..(Signature of the Applicant)
FEE DETAILS
Name of the Bank and Branch ……………………………………………………..……………………………
Demand Draft No. ………………………....Date of Issue………..……………Amount………………..……..
DEPARTMENT OF MANAGEMENT STUDIES, Kumaun University Bhimtal Campus, Bhimtal – 263136
Nainital (Uttarakhand)
Contac no: +91-5942-247136 Tele Fax : +91-5942-247700
E-mail:
INSTRUCTIONS FOR THE APPLICANTS
Read the Information Brochure and Instructions carefully before filling up the Application Form. All the entries in the Application Form should be filled in the applicant’s own handwriting in CAPITAL LETTERS with a ball-point pen.
Item No. 1, 2, 3 and 4 should be filled as mentioned in the High School or equivalent certificate. A copy of the certificate is to be attached.
For item No. 5, 6, 7, and 12 please tick (√) in the appropriate box as applicable. In item No.6
AF-Children of Ex. Armed Forces Personnel; W –Women Candidate;
FF-Dependant wards of Freedom Fighters; H-Handicapped.
A copy of the certificate is to be attached in support of the claim for reserve category.
Complete address should be written in the space provided in Item No. 8.
Applicants should write the name of the Qualifying Examination in item No. 9 as B.A./B.Sc./B.Com./B.Tech. or any other degree whichever is applicable. Candidates who have already passed the qualifying examination should attach a copy of the final Mark Sheet/Degree. Candidates who are appearing/appeared for the qualifying examination are required to submit a certificate from the Head of the Institution/Principal of College in this regard.
Applicants who have already passed the MAT/CMAT/CAT, should attach a photocopy of their MAT/CMAT/CATScore card. Those who are appearing for test by May, 2017, will have to send a copy of theirScore card immediately after declaration of the result.
If there is any gap in your education, write it in item No. 11 giving the reasons thereof and submit an affidavit from the Notary.
All the photo copies of Mark Sheets/Certificates should be duly attested/self attested.
Affix your passport size colourphotograph in the space provided for the purpose and sign across it. Keep six copies of same photograph for admission purpose.
No entry in the application form should be left blank, strike out whichever is not applicable. Incomplete/illegibly filled forms are liable to be rejected summarily and no correspondence shall be entertained in this regard.
Send the completed Application Form in the envelope through Speed Post/Registered Post. The last date for receipt of completed application format in the Department of Management Studies, Bhimtal is 15/06/2017.Downloaded application forms duly filled can be sent in an envelope of appropriate size alongwith a Bank Draft for Rs. 1,000/- (Rupees One Thousand Only) drawn in favour of Finance Officer, Kumaun University payable at Nainital, to the Head, Department of Management Studies, Kumaun University Campus, Bhimtal-263136, Nainital (Uttarakhand).
Choices once filled by the candidate in the form cannot be changed at a later date.
Application forms complete in all respect must reach the Department by notified last date.
DO NOT SENDTHIS SHEET WITH THE APPLICATION FORM