______________________________________________________ _______ Roll No.

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Department of Management Studies

Students Personal Information Form
1. Students Personal Information

*Section 1: To be completed by the student.

Full Name: ...................................................................................................................................................

Date of birth: ..................................... Birth Place:.................................................Blood Group:..............

Local Address:.............................................................................................................................................
...

Tal:..............................Dist:.........................Pin:......................................
Permanent Address:......................................................................................................................................
Tal:..............................Dist:.........................Pin:...............................

Adhar Card No: .............................................................................. Marital status:.....................................

Mobile number: ...................................................Email_Id:.........................................................................

Category:.........................................Caste:....................................Sub-Caste:.............................................
Hobbies & Interest: .....................................................................................................................................

... ....................................................................................................................................................................
2. In Case of Emergency,Please Call:

Name: ....... ................................................................. Relationship to student: ..............................................

Home phone: ............................................................. Mobile phone:...............................................................

3 Academic
3.Guardians Personal Information:

Father's Name: ......................................................................................................... Age:...............................

Mobile No. : ............. .......................................... Email_Id....................................................................

Residence No. : .................................... Place of Work: ................................... Office No.: ...............................

Mother's Name: ............................................ Mothers Age:.............................. Mobile: ..................................

Place of Students residence:

with Parents

with father

with mother

Other, please specify: ...................................................................................

DECLARATION: We hereby declare that the information provided in this sheet is correct and valid to the best of our knowledge. We promise that if there
is any change in the above information, i.e., change in address/contact No./ E-mail ID, etc., it will be our responsibility to inform the
institute. If we do not inform the institute regarding change in information, then whatever financial or academic loss or any other loss
may occur, we and only we will be held responsible for the same. In any case, institute will not be held responsible for the same.

Signature of Parents: _________________

Date: _________________
Place: _________________

Signature of Student: _____________________

Date: _________________
Place: _________________
KKWIEER,Nashik