Application Form for Admission

Student Counselor: Deepika( +91-7092300013 )

Student Details
Name of Student :
Parent's/husbands name :
Gender :
Date of Birth :
Telephone number with area code :
Mobile number :
Email id :
Alternate Email-id:
Course Details
Course Name

Select Elective(s ) : 1.
2.
(2nd Elective applicable only for 1 Yr Executive MBA and 2 Yr MBA)

Course Fee
Payment mode

:
: Online / NEFT / Bank Deposit / DD

Academic & Professional Details :

Academic Qualification:
Employment Status:
Organization Name:
Place of Organization:
Nature of Job :
Contact Details :
Permanent Address

District :
State :
Pin-code :
Communication Address

District :
State :
Pin-code :
Note: Please enter correct and complete communication address as Hard copy of study
material and certificate will be dispatched to same