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Personal Details
Salutation * : Candidate`s First Name * :
Candidate`s Middle Name : Candidate`s Last Name * :
Father`s Name / Husband`s Name * : Mother`s Name * :
Date of Birth (DD/MM/YYYY) * : Age as on 31-12-2010 :
Gender * :
Photo Identity Proof (Carry the same for EMBA-2011, else you will not be permitted for the Test) * :
Academic Background * : If others, please specify :
Nature of Work Experience * : No.of Months of Work Experience * :
Category * :
Present Address
Address Line 1 * : Address Line 2 :
Address Line 3 : State * :
City * : Pin Code * :
Phone Number (eg.912287654321) * : Mobile Number * :
Primary E-mail * : Re-type Primary E-mail * :
Alternate E-mail : Re-type Alternate E-mail :
Is Your Present Address same as Permanent Address? * :
Education Details
X/SSC Percentage * : X/SSC Board * :
State (select where you completed your X/SSC from) * :
XII/HSC/Diploma * :
Bachelor`s Degree Name * : Bachelor`s Degree Percentage * :
College Name * : University * :
Master`s Degree Name : Master`s Degree Percentage :
Program Details
Program Name * :
Test City Details
Test City * :
NMIMS Details
How did you get to know about EMBA-2011? * : If others, please specify :
If Newspaper, which one? :

 
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