APPLICATION INSTRUCTIONS Dear Applicant, You are important to us. We have exceptionally high standards for the talent that we take in our programmes. Superior leadership qualities, communication and interpersonal skills, commitment, problem-solving ability, value driven mindset, professionalism, flexibility, motivation and sharp intellectual curiosity are expected.

Please read the instructions in the Application Form-2014, carefully before you begin to fill your Application. The Application form has to be filled in your own clear and legible handwriting and the undertaking is to be signed by you only.

This Application form is valid for the Amity University - Uttar Pradesh, Campuses in Noida, Lucknow and Dubai, Amity University- Rajasthan, Campus in Jaipur, Amity University - Haryana, Campus in Gurgaon (Manesar) & Amity University - Madhya Pradesh, Campus in Gwalior

• For all details relating to Eligibility & Fee structure kindly refer to the list of programmes at www.amity.edu

• Duly filled in Application Form together with a DD of Rs. 1,100/- (if not paid online) in favour of “Amity Form” payable at New Delhi should be submitted/sent to the respective campus you are applying to : Noida & Dubai Campus : Amity Admission Office, Sector-125, Noida-201 313 (Adj. New Delhi)

Admission Helpline Tel.: 0120-2445252 / 4713600

Lucknow Campus : Amity Admission Office, Malhaur( Near Railway Station), Gomti Nagar Extension, Lucknow-226 010 (UP) Admission Helpline Tel.: 1800-1800-999, 0522-6525675-77

Jaipur Campus : Amity Admission Office, Amity House, 14 Gopal Bari, Ajmer Road, Jaipur-302006, (Rajasthan) Admission Helpline Tel.: 0141-2372489 / 2374595

Gurgaon (Manesar Campus) : Amity Admission Office, Amity International School Campus, Sector-46, Gurgaon-122413, (Haryana) Admission Helpline Tel.: 0124-2337015 / 16

Gwalior Campus : Amity University, Madhya Pradesh, Maharajpura (Opposite Airport), Gwalior-474 005 (MP) Admission Helpline Tel.: 0751-3290666 / 3290667

• Visit www.amity.edu (Admission Microsite Login) for all information relating to your application & admission after submission of application form.

• Qualifying candidates can select their date for Admission Process at www.amity.edu (Admission Microsite Login). It is your responsibility to check the website for selection of date and appear in the Admission Process accordingly. No separate communication will be sent in this regard.

• You are advised to keep a photocopy of the complete application form.

• Incorrectly filled, incomplete, unsigned forms & forms received after due date will be rejected.

• Forms once rejected will not be reconsidered & form cost will not be refunded.

• You cannot apply more than once for the same programme in one admission year.

• Enclose class 10th mark sheet only with the Application Form. No other Mark sheets / Testimonials are to be attached with the Application Form at this stage (Only foreign students / Foreign University Degree holder should attach photocopies of academic transcripts & AIU Equivalence Certificate). University / Board / Marks filled in the Application Form will be considered for all procedures related to admission. Any discrepancy found during original document verification will result in cancellation of Admission.

• Amity does not take any responsibility for delay or loss of the material in post/transit.

We do not accept any donations for admission. Merit is the only criteria.

Any instances found, even at a later date, will lead to cancellation of admission.

1. Please read the instructions in the Admission Prospectus-2014 before filling up this form.2. Use BLACK BALL POINT PEN to write in the boxes using English capital letters or English numerals.3. Do not make any stray marks on this sheet4. Do not staple, pin, wrinkle, scribble, tear,wet or fold this sheet.5. Write in CAPTIAL LETTERS only within the box, in your own handwriting without touching the lines as shown in the sample below.

0 1 2 3 4 5 6 7 8 9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

4. PHYSICAL STANDARD

Application Form Number

Height

ft. inch.

Weight

1. NAME OF THE CANDIDATE (as in candidate's class X marksheet or equivalent certificate - enclose photocopy)

2. MOTHER'S NAME (as in candidate's class X marksheet or equivalent certificate)

3. FATHER'S NAME (as in candidate's class X marksheet or equivalent certificate)

5. GENDER

Male

Female

6. CATEGORY

GEN

SC

ST

OBC

7. NATIONALITY

Indian Others

If Other Specify

8. PROGRAM APPLYING FOR (You may be offered option-2 in case you do not qualify for option-1.

Choose option-2 from list of programs under same eligibility. Refer Admission Prospectus - 2014 for program code)

Option-1 Option-2

Program Code

9. DATE OF BIRTH(as in candidate's class X marksheet or equivalent certificate)

- -D D M M Y Y Y Y

10. ADMISSION CATEGORY (Refer admission prospectus - 2014 for fee) 11. HOSTEL ACCOMMODATION

Yes No If "YES" AC Non AC

12. PREQUALIFYING TEST (If applicable) for MBA Programs for B Arch Program

Date of Test D D M M Y Y Y YMAT Form No.

15. MANDATORY E-MAIL ADDRESS (Only in Capital Letters)

16. Write your complete Correspondence address including your name in English in Capital Letters with Black Pen. (For any communication related to your admission)

Name :

Address :

City : State :

Postal Code (PIN/ZIP) :

Write application Form No at theback of a recent color

Photograph(size: 3.5x4.5cm)& paste (do not staple).

Do Not Attest

18. PHOTOGRAPH

(Within the Box Only)

17. SIGNATURE OF THE CANDIDATE (Within the Box only)

1

INSTRUCTIONS

kg.

Program Code

Non-Sponsored Sponsored Company Sponsored NRI Foreign

NATA

Score

MAT/CAT/GMAT/XAT/NATARoll Number(or) ID

Percentile .

Country :

D D M M Y Y Y YValidityRequire Student VISA?

Yes No

13. PASSPORTNo.

14. Contact NumbersCountry Code

+

Mobile Number Landline phone number with STD(area) code

(Applicable forDubai Campus)

MAT CAT GMAT XAT

7849

5328827

User Name : 5328827Password : monika

M O N I K A P A N D E Y

1 0 1 3 9 1 1 0 4 1 9 9 0

+ 9 1 7 3 7 6 3 0 5 7 5 0

M O N I B H A R D W A J . 1 2 3 @ G M A I L . C O M

NO OF BACK PAPER(S)(If not cleared till date)

2

19. EDUCATIONAL QUALIFICATIONSIt is mandatory to fill all details of educational qualification (as applicable) from class X onwards till last completed semester/year. if the system of marking of your school/college is on gradingpattern, convert grade into marks as applicable and fill in the respective columns. In absence of complete information, form will be rejected.

Passing Year

.

CLASS X CLASS XII

CLASS XII BOARD RESULT DETAILS

Medium of instruction English Hindi Others

SUBJECT NAME MARKS OBTAINED MAXIMUM MARKS GRADE / POINTS (FOR INT. BOARDS)

XII Board Name (Recognised Board only) XII Board Roll No.

GRADUATION DETAILS Medium of instruction English Hindi Others

Name of Degree Branch/Subject of specialization (if any)

SEMESTER/YEAR

MARKSOBTAINED

MAXIMUM MARKS

SGPA*/AGPA* OBTAINED

*Grade point scale used

Semester/Year wise MarksDuration of Degree

Years Months

Scheme of Examination

Semester Annual

Discipline

Arts

Commerce

Engineering

Management

Science

Others

Full Time

Part Time

Correspondence

Mode of study

XII School Name

City

1

2

3

4

5

6

7

8

9

10

BoardCBSE ICSE NIOS OTHERS

Aggregate percentage of all subjects onclass X marksheet (enclose photocopy)

BoardCBSE ICSE NIOS OTHERS Passing Year

(Provide details of all subjects as in class XII marksheet)

/ .

/ .

/ .

/ .

/ .

/ .

/ .

/ .

/ .

/ .

(please fill either MARKS or GPA information based on the evaluation system)

Pin / Zip Code

Application Form No.

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3

Name of the College (Graduation)

City

Name of the University (Graduation)

POST GRADUATION DETAILS

Name of Degree Branch/Subject of specialization (if any)

YearsAttended From Y Y Y Y

UniversityEnrollment No.Y Y Y YTo :

*Grade point scale used

21. EMPLOYMENT HISTORY (if applicable) Work Experience? Yes No

Graduation - YearsAttended From To :

UniversityEnrollment No.

Medium of instruction English Hindi Others

Last Organisation Nameif "Yes", total yearsof work experience

Years Months

Last Designation

Date From Date To

D D M M Y Y Y Y D D M M Y Y Y Y

Last salary drawn per month in INR Full-Time

Part-Time

22. FAMILY INFORMATION Parent Email ID (only in capital letters)

Pin / Zip Code

20. AWARDS / ACHIEVEMENTS (if any, latest two) Proof will be verified on the day of selection

Name Received when For what

NO OF BACK PAPER(S)(If not cleared till date)

SEMESTER/YEAR

MARKSOBTAINED

MAXIMUM MARKS

SGPA*/AGPA* OBTAINED

Semester/Year wise Marks

/ .

/ .

/ .

/ .

/ .

/ .

(please fill either MARKS or GPA information based on the evaluation system)

1

2

3

4

5

6

Mode of Study Full Time Part Time Correspondence

Country Code Father's Mobile No. Country Code Mother's Mobile No.

Application Form No.

Name of the University (Post Graduation)

City

Years Months

Semester AnnualScheme of Examination

Duration of Degree

Discipline

Arts Commerce

Engineering Management

Science Others

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4

24. FAMILY AT AMITY (if applicable)

25. CORRESPONDENCE ADDRESS (same as point 16)

Address

City :

State :

26. WRITE YOUR COMPLETE PERMANENT ADDRESS (if different from correspondence address)

27. Do you suffer from any chronic ailment or disability : Yes No

If "Yes" give details:

29. Details of Payment of Form

30. SIGNATURE

PIN / ZIPCode :

Institute Name

Program Name (if Student / Alumni) / Designation (If Employee)

Duration

Any of your family members associated with Amity as Employee Student Alumni

Y Y Y Y

Year ToYear From

Y Y Y Y

What is the relation to you?

Grandparent Parent Spouse Sibling

Address :

City :

State :

Have you previously applied to Amity ? Yes No

Previous Form No. :

DesignationOrganisationProfessionAge

Father

Mother

Qualification

23. PREVIOUSLY APPLIED

Year Were you Selected ? Yes No

Name of the Family Member

Country

Country

PIN / ZIPCode :

Application Form No.

DD No. MICR No. Date :

Online Transaction No. Receipt No. Date :THROUGH ONLINE

BY DEMAND DRAFT - -D D M M Y Y

(9digit number next to DD No. on the Demand Draft)

Signature : Date :

I hearby certify that the information given in the Application (all relevant Forms) is complete and accurate.I understand and agree that misrepresentation or omission of facts will justify the denial of admission, the cancellation of admission, or expulsion.I have read, understood and do hereby consent to the Terms & Conditions for Admission as mentioned in Admission Prospectus 2014.I have enclosed photo copy of class X marksheet or equivalent certificate.

Foroffice use

only

If "Yes" please explain on a separate sheet of paper.

28. Have you ever been suspended, dismissed or put on academic probation or warning at any school or college?Yes No

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