JAGRAN INSTITUTE OF MANAGEMENT Admission Form.pdf · JAGRAN INSTITUTE OF MANAGEMENT 620, W Block...
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JAGRAN INSTITUTE OF MANAGEMENT 620, W Block Saket Nagar - Kanpur - 208014 (Approved by AICTE, Ministry of HRD Govt. of India and Affiliated to Dr.APJAKTU, Lucknow) Ph.No: 0512 - 2601126 APPLICATION FORM For Admission to Post Graduate Diploma in Management (PGDM) Affix Photograph (For Office use only) CAT/MAT/CMAT/XAT/ATMA/JMAT Any other entrance exam STUDENT'S DETAILS Full Name (Block Letters) Date of Birth m m d d m y y y y GENDER : Male Female Mobile Number m Email CORRESPONDENCE ADDRESS PERMANENT ADDRESS Father’s Name Father's Occupation ACADEMIC QUALIFICATION Name of the School / College Board / University Year of Passing Percentage of Marks High School Intermediate Company sponsored m Graduation BA/B.Sc./ B.Com./BBA/BCA/Others NOTE: Please attach the self attested photocopies of the following documents. ENCLOSURES (i) Mark sheets / Passing Certificates (ii) Score card of Competitive tests (iii) Work Experience Certificate (if applicable) (iv) 2 Colour Pass Port Size Photographs Details of the DEMAND DRAFT DD No. m m d d m y y y y Dated Amount Bank & Branch Name (v) Company sponsor letter - if applicable Amount in words Amount Amount in words I declare that all the particulars provided by me above are true DECLARATION Signature Date Application Form No. : JIM/KNP/PGDM/2019-21/014/ CATEGORY : GEN/SC/ST/OBC/Minority Mother’s Name Gaurdian's Contact No. Guardian's Email (vi) Adhar card & Voter ID
Transcript of JAGRAN INSTITUTE OF MANAGEMENT Admission Form.pdf · JAGRAN INSTITUTE OF MANAGEMENT 620, W Block...
JAGRAN INSTITUTE OF MANAGEMENT
620, W Block Saket Nagar - Kanpur - 208014
(Approved by AICTE, Ministry of HRD Govt. of India and Affiliated to Dr.APJAKTU, Lucknow)
Ph.No: 0512 - 2601126
APPLICATION FORM
For Admission to Post Graduate Diploma in Management (PGDM)
Affix Photograph
(For Office use only)
CAT/MAT/CMAT/XAT/ATMA/JMAT
Any other entrance exam
STUDENT'S DETAILS
Full Name (Block Letters)
Date of Birth
m md d m y y yy
GENDER :
Male
Female
Mobile Number
m
CORRESPONDENCE ADDRESS
PERMANENT ADDRESS
Father’s Name
Father's Occupation
ACADEMIC QUALIFICATION
Name of the School / College Board / University
Year of Passing
Percentage of Marks
High School
Intermediate
Company sponsored
m
GraduationBA/B.Sc./ B.Com./BBA/BCA/Others
NOTE: Please attach the self attested photocopies of the following documents. ENCLOSURES
(i) Mark sheets / Passing Certificates
(ii) Score card of Competitive tests
(iii) Work Experience Certificate (if applicable)
(iv) 2 Colour Pass Port Size Photographs
Details of the DEMAND DRAFT DD No.
m md d m y y yyDated
Amount
Bank & Branch Name
I declare that all the particulars provided by me above are true SIGNATURE
DECLARATION
(v) Company sponsor letter - if applicable
Amount in words
Amount
Amount in words
I declare that all the particulars provided by me above are true
DECLARATION
Signature Date
Application Form No. : JIM/KNP/PGDM/2019-21/014/
CATEGORY : GEN/SC/ST/OBC/Minority
Mother’s Name
Gaurdian's Contact No.
Guardian's Email
(vi) Adhar card & Voter ID
