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Registration Form


First Name
Middle Name
Last Name
Nationality
Blood Group
Dath of Birth:
Gender:
Male
Female
Aadhaar Number
PAN Number
Your Permanent Address
City
State
PinCode
Current Address
City
State
PinCode
Mobile NO:
Email ID:
Parent/Guardian Information:
Father's Name
Occupation
Mother's Name
Occupation
Address
Mobile
Email
Family Annual Income
Academic Record
Class X :
School/Institution
Board/University
Year of Passing
Specialization
Percentage/CGPA
Class XII :
School/Institution
Board/University
Year of Passing
Specialization
Percentage/CGPA
Graduation :
School/Institution
Board/ University
Year of Passing
Specialization
Percentage/CGPA
Other Qulification (If Any) :
School/Institution
Board/ University
Year of Passing
Specialization
Percentage/CGPA
Category :
General
OBC
SC
ST
Other
Entrance Exam :
CAT
MTA
CMAT
ATMA
MHCET
Score :

Work Experirnce (If Any) :
Organization
Duration
Role
Why do you want to pursue this course? Sepecialization willing to opt in 2 nd Year:
* How did get to know about MBA@IICMR :
Advertisement Alumni Friend
Other
Declaration by the candidate

"I declare that I am applying for admission with the consent of my parents/guardian and that the particulars given above are correct. I have read the college prospectus as well as the admission requirements as laid down by the University for the Course. I agree to abide by the rules and regulations given therein. I understand that my admission if made by the college is provisional and will be subject to confirmation by the University. In case my admission is cancelled by the University I shall have no claim for refund of fees paid by me to the college or the University

I undertake that I shall not indulge in any act of ragging otherwise my admission to the college stand cancelled and disciplinary proceedings be initiated against me"

Date :
Place :
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