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APPLICATION FORM FOR ADMISSION TO FIRST YEAR OF TWO-YEAR FULL-TIME POST GRADUATE COURSES IN MANAGEMENT VIZ. MBA/MMS/PGDBA/PGDBM FOR THE ACADEMIC YEAR 2012-13 APPLICATION ID : MB12159501 VERSION NO : 4 SEATNO:28030003
Personal Details : Full Name AGRAWAL LAKHAN PURUSHOTTAM Candidature Type Maharashtra - Type A Date Of Birth August 5, 1991 Region Urban Annual Family 50,000 - 1,00,000 Income Applied for EBC ? No PH Type NA Home University Mumbai University Pay-in-Slip No / Receipt No 417504 Amount( ) 1150/Axis Bank Branch Vashi Qualification Details : Qualification 10th / S.S.C. / Equivalent 12th / H.S.C. / Equivalent Graduation Faculty Graduation University District of Passing H.S.C. Appeared For All India Exam Date Febuary 1, 2012 Category Open Gender Male Religion Hindu Mother Tounge Hindi
PAR 2 2
Graduation Status Appearing Graduation Type Full-Time District of Passing Thane Graduation Exam Name - CAT-2011, Prometric Testing ID - SR7490170, CAT E-Mail ID - LAKHANAGRAWAL05@GMAIL.COM, CAT Percentile - 62.93, CAT Marks 164
I am attaching the attested true copies of following required documents as per the sequence given herewith. [Candidate is required to show original documents for verification at ARC]
Sr. No. 1. 2. 3. 4. 5. 6. 7. Pay-in-Slip of Application Processing Fee. Proforma - I on Plain Paper (The Candidate who is not able to submit Indian Nationality Certificate is required to submit Proforma - I on Rs. 100/-Non-Judicial Stamp Paper). Certificate of Indian Nationality in the Name of the Candidate. Domicile Certificate clearly indicating the place of permanent residence issued by SDO / Dy. Collector of District. Statement of Marks or Certificate of Passing of Std. 10th / S.S.C. / Equivalent Examination. Statement of Marks or Certificate of Passing of Std. 12th / H.S.C. / Equivalent Examination. Score Card of CAT - 2011. Document Name
Declaration
I have read all the rules of admission and on understanding these Rules, I have filled this Application Form for consideration of submission of Application Form at ARC for the admission to MBA/MMS for the academic Year 2012-2013. The information given by me in this application and in Proforma-I is true to the best of my knowledge & belief. If at later stage, it is found that I have furnished wrong information and/or submitted false certificate(s), I am aware that my admission stands cancelled and fees paid by me will be forfeited. Further I will be subject to legal and/or penal action as per the provisions of the law. Place : Date:
http://www.dte.org.in/mba/CandidateModule/frmPrintApplicationForm.aspx
4/19/2012
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http://www.dte.org.in/mba/CandidateModule/frmPrintApplicationForm.aspx
4/19/2012