COLLEGE OF BUSINESS MANAGEMENT, ECONOMICS AND COMMERCE

… A Premier Women B-School with Indian Ethos and Values

COLLEGE OF BUSINESS MANAGEMENT, ECONOMICS AND COMMERCE

… A Premier Women B-School with Indian Ethos and Values

1. PROGRAM APPLIED FOR :

2. Full Name of the Candidate (In Capital Letters as recorded in 10th class certificate ) :

_______________________________________________________________________________________

3. Father’s Name: __________________________________________________________________________

4. Mother’s Name: _________________________________________________________________________

5. Address for Correspondence: ______________________________________________________________

_______________________________________________________________________________________

City: __________________ State:________________ Pin Code: _____________ Country: ______________

6. Permanent Address: _____________________________________________________________________

_______________________________________________________________________________________

City: __________________ State:________________ Pin Code: _____________ Country: ______________

7. Phone No. with STD Code: _________________________________________________________________

8. Mobile No.: Student: ______________________________ Parent: ________________________________

9. Email ID: Student: ________________________________ Parent: ________________________________

10. Date of Birth: __________ 11. Blood Group: _____ 12. Religion: _________ 13. Marital Status: ________

13. Category : Gen ST SC OBC Others

14. Nationality: Indian NRI Foreigner

A. If Indian, Whether from North East Yes No

B. Foreigner, Country SAARC Others

15. How did you come to know about Mody University? 1. Google 2. Social Media 3. News Paper / Magazine 4. Radio 5. TV 6. Parents / Relatives 7. Friends/Peers 8. Mody School Pass out 9. Education Fair 10. Others

Affix latest Passport Size

Color Photograph

MBA (Dual Specialization)

MBA (Family Business & Entrepreneurship)

M.Com

B.Com (Hons.)

BBA

Dual Degree BBA-MBA

BA (Hons.) Economics

COLLEGE OF BUSINESS MANAGEMENT, ECONOMICS AND COMMERCE

… A Premier Women B-School with Indian Ethos and Values

16. Educational Qualifications (10th onwards):

(Name and Address of the Educational Institution last attended): _________________________________

_____________________________________________________________________________________

Examination Qualified /Appeared

Board/University Year of Passing

Marks %/CGPA

Subjects

X

XII

Graduation: B.Tech/ B.Com/B.Sc./BA/BBA

Any Other, Please Specify

_________________

17. Entrance Test Score (for MBA applicants only): ________________________________________________

CAT XAT NMAT CMAT MAT MMET

18. Work experience, if any (for MBA applicants only): No. of years: _________________________

Designation: ___________________________ Organization: ________________________________

19. Write in a few words, why you want to pursue this program (Applicable for MBA only):

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

20. Preferred Center for online Test (MMET):* ____________________________________________________

Agra, Ahmedabad, Ajmer, Ambala, Amritsar, Bhopal, Bikaner, Bokaro, Chandigarh, Dehradun, Ghaziabad, Gurgaon, Guwahati, Gwalior, Hanumangarh, Hisar, Indore, Jabalpur, Jaipur, Jammu, Jamshedpur, Jodhpur, Kanpur, Kolkata, Kota, Lakshmangarh, Lucknow, Ludhiana, Mathura, Mumbai, Muzaffarpur, New Delhi, Noida, Patna, Raipur, Ranchi, Rohtak, Shimla, Udaipur,Sri Ganganagar.

(*For MBA applicants only; Venues Subject to change, please see website for updates.)

21. Parent's Annual Income INR _______________________________________________________________

22. Guardian’s Name & Occupation (if other than parent) __________________________________________

___________________________________________________________________________________

23. Accommodation: Hostel Seat Required: AC Non AC Own Arrangement

(Note: a. Hostel allotment may be done on semester basis. b. Allotment of room/seat is subject to availability. c. No withdrawal is permitted in the middle of the session July to June.)

24. Application Fee Details (In case of downloaded application form): DD No: __________________________________ Amount: _______________________________ Bank: ___________________________________ Date: __________________________________

COLLEGE OF BUSINESS MANAGEMENT, ECONOMICS AND COMMERCE

… A Premier Women B-School with Indian Ethos and Values

DECLARATION

I, ………………………………………………... , declare that all the information given in this application form is true to the best of my

knowledge. I assure that I shall abide by all the rules and regulations of the University, which are in vogue now as well as

those, which come into force from time-to-time. I further assure that I shall do nothing inside or outside the University

that goes against the discipline and orderly working of the University. I understand that if (1) any information herein is

found to be incorrect, (2) I am found indulging in any act of indiscipline or (3) I fail to pay the dues in time, I shall be liable

to any punishment as awarded by the University, which may even include striking off my name from the rolls of the

University.

Place: Date: Signature of the Candidate

DECLARATION FROM THE PARENT/GUARDIAN

I, ........................................................ , Father/Mother/Guardian of Ms. __________________________ who is a candidate

for admission to the University; certify that I am the bonafide parent / guardian of the candidate. I assure that the

candidate and I shall abide by all the rules and regulations of the University, which are in vogue now as well as those,

which may come into force from time-to-time. Also, all the required fees shall be paid in time.

Place: Date: Signature of the Parent/Guardian

(For office use):

Copies of documents have been checked with originals and verified.

______________________

(Signature of Verifying Officer)

Admission offered in ___________________________________

____________________________ __________________

Signature of Chairman Admissions Signature of the Dean

Deposition of Fee/Charges:

Fee/Charges of Rs _______________ Deposited by CASH/DD vide receipt No. ________________Dated. _____________

___________________________

Signature of the Receiving Officer

Enclosures (Please attach self-attested copies of):

1. Mark Sheet and Certificate of Class X

2. Mark Sheet and Certificate of Class XII

3. Mark Sheet and Certificate of Graduation and above

4. Migration Certificate

5. TC/CC Certificate

6. Certificate/Mark sheet of valid CAT/XAT/NMAT/CMAT/MAT test score*

7. Student Visa**

8. Passport**

9. Residential Permit**

(*For MBA applicants only; **Applicable for NRI and Foreign National.)