MAHARAJA AGRASEN INSTITUTE OF MANAGEMENT STUDIES

(AFFILIATED TO GURUGOBIND SINGH INDRAPRASTHA UNIVERSITY, DELHI)

MAHARAJA AGRASEN CHOWK, PSP AREA, PLOT NO. 1, SECTOR-22, ROHINI,DELHI-110041
TELEPHONE: 011-65195341 & 011-27582078 (TELE-CUM-FAX)

NOTE : FILL IN THE FORM IN CAPITAL LETTERS

PROGRAMME :

BBA BBA (SS)

BBA (B&I) BBA (B&I)(SS)

BJMC BJMC (SS)

University Roll No :

Date of Birth :

Blood Group :

Name of the Candidate :

(as per matriculation record)

Communication Address (Present) :

Telephones : Landline : Mobile:

e-mail :

Communication Address (permanent):

Telephones : Landline : Mobile :

e-mail :

Categories : Gen : SC : ST : OBC :

Gender : MALE : FEMALE :

Roll No. and Rank in Guru Gobind Singh Indraprastha University’s Common Entrance Test .

Roll no. Rank

Fees deposited in MAIMS : ₨.

Academic Qualifications :
Examination School Board/ Year Subject of Studies Marks % of Division
University Obtained Marks/Grade

Class X

Class XII

Parents Particulars :
Father’s Name :
Occupation & Designation :
Official Address :
Telephones : Landline : Mobile :
e-mail :
Mother’s Name :
Occupation & Designation :
Official Address :
Telephones : : Landline : Mobile :
e-mail :
“ Ragging is Prohibited as per the decision of the Supreme Court of India in Writ
Petition No. (C) 656/1998”. If I am, at any stage during my entire programme in the Institute,
found indulging in any act if ragging, appropriate action should be taken as per the rules and
regulations of the Government of India, UGC and GGSIP University/institute.
Declaration by Candidate
I hereby declare that the information given above has been filled by me and is correct to the best of
my knowledge and belief

Signature of the student with date Signature of the parent/Guardian with date