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ACADEMIC YEAR : ____________________

COURSE : __________ Roll No. :________


Maratha Mandirs

BABASAHEB GAWDE INSTITUTE OF MANAGEMENT STUDIES

nd

Floor, Babasaheb Gawde Chowk, Dr.A.B. Nair Road, Mumbai Central, Mumbai 400 008.

-------------------------------------------------------------------------------------------------------------------------------------------ADMISSION FORM

INSTRUCTIONS
(1) Submit photocopy of statement of marks of last two semesters.
(2) Submit NINE latest colour photographs.
(3) Fill in the application form completely and correctly. In case of overwriting, the form will be rejected.

-----------------------------------------------------------------------------------------------------------------------------------------------------------A. Candidates General Information :


1. Name :

_____________________
Surname

_____________________

_____________________

First Name

Middle Name

(Note : Name should be exactly as mentioned in S.S.C. certificate)

2. Gender : __________________
3. Local Address (for Correspondence & Railway Concession) : _________________________________________
_____________________________________________________________________________________________
_____________________________________________________________

Pin Code : _________________

4. Telephone No. : ___________________ 5. Mobile No. : ____________________________________________


6. Email ID : ____________________________________ 7. Adhar No.___________________________________
8. Bank Account for E-Transfer: (for repayment like deposit etc., if any)
i) Name of the Account Holder : ________________________________________________________________
ii) Name of the Bank & Branch : _______________________________________________________________
iii) Bank A/c No. : __________________________ iii) IFSC No. : ______________________________________
(Attach Photocopy of Cheque)
B. Family Information :
Fathers Information :
1. Fathers Name : ______________________________________________________________________________
(Please Indicate if deceased / retired / divorcee) : ______________________________________________________
2. Education : ____________________ 3. Occupation : ______________________ 4. Age : _________________
5. Name & Address of Office : _____________________________________________________________________
______________________________________________________________________________________________
__________________________________________________________________ Pin Code : __________________
6. Specify if Govt. employee : _____________________________________________________________________
7. Telephone No. : _____________________________ 8. Mobile No. : _________________________________
9. Email ID : ___________________________________ 10. Gross Annual Income : ________________________
Mothers Information :
1. Mothers Name : _____________________________________________________________________________
(Please Indicate if deceased / retired / divorcee) : ______________________________________________________
2. Education : ____________________ 3. Occupation : _____________________

4. Age : ________________

5. Name & Address of Office : _____________________________________________________________________


______________________________________________________________________________________________
_____________________________________________________________

Pin Code : __________________

6. Specify if Govt. employee : _____________________________________________________________________


7. Telephone No. : ______________________________ 8. Mobile No. : _________________________________
9. Email ID : __________________________________ 10. Gross Annual Income : _________________________

Tobacco / Cigarette Prohibited

[1]

Ragging Prohibited

C. Guardians Information :
(Only if candidate not staying with parent)
1. Name of Local Guardian : ______________________________________________________________________
2. Relationship with the applicant: _________________________________________________________________
3. Residential Address : _________________________________________________________________________
_____________________________________________________________________________________________
________________________________________________________________ Pin Code : __________________
4. Education : ____________________ 5. Occupation : ____________________ 6. Age : __________________
7. Name & Address of Office : ____________________________________________________________________
_____________________________________________________________________________________________
_______________________________________________________________

Pin Code : __________________

8. Specify if Govt. employee : ____________________________________________________________________


9. Telephone No. : ________________________________

10. Mobile No. : _____________________________

11. Email ID : ____________________________________

12. Gross Annual Income : ____________________

D. Additional Information :
1. Summer Placement Details :
a. Name of the Company : _______________________________________________________________
b. Project Title (if any) :___________________________________________________________________
c. Duration (Mention Dates ) : From ______________________

To _________________________

d. Have you submitted summer Placement appointment letter issued by the company to the institute?
Yes

No

E. Declaration by the Candidate and the Parent / Guardian :


I / we declare that I / my ward shall abide by all rules and Code of Conduct of the institute which I / we have read
and understood. Especially I / we declare that the rule of attire that the male students should not wear lehenga,
zabba and / or any kind of cap and female students should not wear burkha any time in the institutional campus will
be strictly followed by me / my ward. I / we also declare that I / my ward will abide by instructions, rules etc. of the
competent authority (University of Mumbai, DTE and / or other authorities) and also Laws in force from time to time.
F. I /we understand & agree that the deposit will be refunded at the time of leaving institute after completion of
programme successfully after deducting Alumni Association fee, common breakage & other dues etc.

Candidate Signature :

Parents / Guardians Signature :

Date :

Name of the Parents / Guardians

Place :

Relation with Candidate :

-----------------------------------------------------------------------------------------------------------------------------------------------------------Recommended for Admission


Fees (Rs.) :
Authorized Signatory
Cash/Draft/Cheque No.
Bank Name :
Receipt No.

Tobacco / Cigarette Prohibited

[2]

Ragging Prohibited

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