Welingkar

S.P. Mandali’s Prin. L. N. Welingkar Institute of Management Development & Research

Form Number Page - 1

ADMISSIONS TO THE

PGDM PROGRAMS 2012-2014 AT MUMBAI AND BENGALURU CAMPUS

RECOGNISED BY AICTE, GOVT OF INDIA, NEW DELHI

Form No: XXXX

PART A

Personal Details

1. Full Name:

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

2. Date of Birth:

Phone-022241415733

3. Program(s) applied for (in order of preference):

Preference 1:

Preference 2:

Preference 3:

Preference 4:

Preference 5: Signature

Preference 6:

Preference 7:

Preference 8:

4. Educational Qualification:

Class 10:

Passing Month and Year:

School:

Board/ University:

Percentage: Class: GPA: Grade:

Class 12:


College:

Board/ University:


Graduate Degree:


College:

Board/ University:


Total Marks: out of :

Post Graduate Degree:


College:

Board/ University:


Affix recent

Passport Size colour photograph

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SHRESHTA KHIMESRA

4 September 1990

PGDM – MumbaiPGDM eBusiness – MumbaiPGDM - BengaluruPGDM eBusiness – BengaluruPGDM Business Design - MumbaiPGDM Business Design - Bengaluru CampusPGDM Retail Mgmt – Mumbai

SSC2006May

VIVEKANAND VIDYA VIHARCBSE

78.60 distinction

HSC in SCIENCE (PCM)2008May

VIVEKANAND VIDYA VIHARCBSE

74.00 first class

B.Tech in ELECTRONICS & COMMUNICATION2012May

JAIPUR NATIONAL UNIVERSITYJAIPUR NATIONAL UNIVERSITY

Ap appearing

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5. Additional PG / Diploma:

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XXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

6. Computer Proficiency:

MS Word Internet Usage Adobe creative suite

MS Excel Email Usage CorelDRAW

MS Power Point None Google sketchup

MS Access

XXXXXXXXXXX

7. If you are active on social networking media, mention your ids on

a. LinkedIn:

b. Facebook:

c. Twitter:

8. Work-Experience after graduation: 100 Total Months:50

Organisation: m

rganization01

Designation:

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

From: Sept 2002 AN 30 2005 To: Nov 2006 JAN 30 2005 Months: 5010

Description of work: Handling the Reliance EPABX System. Maintaining the entire

the Plant

0

Organisation:

rganization01

Designation:




the lant

0

Organisation: R

rganization01

Designation:




the

Plant

0

0

0

0

XXX

XX

[email protected]

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9. Work-Experience during graduation:

Organisation:

rganization01

Designation: Nature of work:



Description of work: Handling the Reliance EPABX System. Maintaining the entirent

0

Organisation: R

rganization01

Designation: Nature of work:




th0

10. Family Background:

Father:

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

Occupation: Highest Qualification:

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

Organization: Steel Authority of India X

XXXXXXXXXXXXXXXXXXXXXX

Designation: Manager


Mother:

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX



Organization: N/A

XXXXXXXXXXXXXXXXXXXXX

Designation: N/A


Sister/Brother:

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

Occupation: S Highest Qualification:


Organization: NMIMS NMIMSX

XXXXXXXXXXXXXXXXXXXXX

Designation: Student

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

Sister/Brother: N/A XX

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX



Organization: N/A

XXXXXXXXXXXXXXXXXXXXXXX

Designation: N/A X

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

0

0

SANJAY KHIMESRA

SERVICE DAM

BIRLA CENTURY

JOINT PRESIDENT

KAVITA KHIMESRA

HOUSE-WIFE B.Sc (Home Science)

-

-

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PART B

Kindly handwrite your response. Do attach any extra sheets if required

(Compulsory for all applicants)

11. State 3 of your strengths and weaknesses.

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12. What would you say are your hobbies or interests?

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13. Mention the states traveled within India and countries traveled to outside

India, if any

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14. Mention your achievements, both academic/non-academic in the last 5 years.

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15. Mention names of any 2 books you have read in the last 1 year.

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16. In not more than 75 words describe why you want to pursue Management

Education.

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17. If there is anything you think we should know while we evaluate you,

use the space below. However if we have captured everything through

the form above, you may skip this question.

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PART C1

(To be filled only by candidates applying to the PGDM E-BUSINESS program)

18. What interests you about the PGDM e-Business program at Welingkar?

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19. What according to you is the role of e-Business in today’s business

scenario?

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20. Which of your qualities or personality traits will help shape a career in e-

Business?

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21. What type of work/career do you aspire for – highlight sectors/verticals

and job roles of your interest?

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PART C2

(To be filled only by candidates applying to the PGDM BUSINESS DESIGN program)

22. What interests you about the PGDM Business Design program at Welingkar?

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23. How do you think design thinking is related to Businesses?

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24. Describe in brief any creative work that you have done, cite as many

examples as possible

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25. What type of work/career do you aspire for – highlight sectors/verticals

and job roles of your interest?

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PART C3

(To be filled only by candidates applying to the PGDM RETAIL MANAGEMENT)

26. According to you, which of your personality traits will help you in shaping a

successful career in the retail industry?

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27. Name any retail personality that you admire; either International or Indian,

and why?

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28. If you were given the opportunity to open your own retail store, what kind

of store will that be?

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29. In case you have worked in the retail industry before, what is the part of

your job that you liked the most and why? What did you dislike the most

and why?

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PART C4

(To be filled only by candidates applying to the PGDM HEALTHCARE MANAGEMENT)

30. Do you think the healthcare industry needs management professionals?

What is the role of such management professionals in the healthcare

industry today?

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31. What personality traits do you think a management professional in

healthcare industry requires? Which of these traits do you possess?

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32. Which specific sectors/ verticals within the healthcare industry would you

be interested in? Why?

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33. If given the opportunity to start your own project in healthcare, what

would be your focus - service, cost, quality, profit, innovation, and others?

Justify?

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Welingkar

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