Personal
Details |
Salutation |
This is a mandatory field. Please
select the appropriate option. |
First Name * |
If your
name is Kshitij Mathur, then ‘Kshitij’ is the first name, and
‘Mathur’ is the second name. If you do not usually use a
middle name or do not have a middle name, just leave the field
blank. |
Middle Name |
If you have a middle name please
fill in your middle name. For example if your full name is
Siva Rajkumar Raghunathan, then fill in ‘Rajkumar’ as
the middle name. |
Last Name* |
Last name/Surname or family name.
This may often be your father’s name or a common last name in
the family. |
Date of birth* |
The
format is dd-mmm-yyyy (e.g.19-Feb-1981) |
Gender * |
Simply
click the relevant button. |
Nationality * |
Select your nationality from the drop down. |
Upload Photo(Only .jpg or .jpeg or .gif formats, Upto 100 KB) |
Upload Photo |
Upload your recent photograph. |
Present
Address |
Present Address Line 1 * |
Enter
your door number, apartment number in the address line 1 field. |
Address Line 2 |
Enter your street address. |
Address Line 3 |
Enter your locality name. |
City * |
Enter the city where you are located at present. |
State * |
Select
the state where you are located at present. |
Country * |
Enter the country name.
|
Pincode * |
Enter your area pincode (Note:
Fill only numeric characters only (0-9). Do not leave spaces
in between). |
STD Code* |
Enter the STD code
city (For e.g. 0444234522). |
Phone Number (With STD Code) * |
Enter the code and phone number of your
city (For e.g. 0444234522). |
Mobile Number * |
Enter your mobile number. |
Fax |
If you have any Fax number
please fill it in this column. |
Primary Email * |
Please
enter the email address.For e.g. [email protected].
Do not use anyone else’s email address. |
Retype Primary Email * |
Please retype the Primary Email ID. |
Alternate Email |
Please
enter the alternate email address. |
Retype Alternate Email |
Please retype the Alternate Email ID. |
Is Permanent address same as
Present Address |
If the answer is YES, please
indicate. If the answer is NO, you will have to fill in your
permanent address in the fields that appear. |
Permanent Address Line 1 * |
Enter
your door number, apartment number in the address line 1 field. |
Address Line 2 |
Enter your street address. |
Address Line 3 |
Enter your locality name. |
City * |
Enter the city where you are located at present. |
State * |
Select
the state where you are located at present. |
Country * |
Enter the country name.
|
Pincode * |
Enter your area pincode (Note:
Fill only numeric characters only (0-9). Do not leave spaces
in between). |
PDGM Programme Preferences |
Preference 1 * |
Select Appropriate option |
Preference 2 * |
Select Appropriate option. |
Preference 3 |
Select Appropriate option. |
Details of Entrance Test |
Name of the Entrance Test* |
Enter name of exam if any. |
Test Date (e.g. 22-Apr-2013)* |
Enter the date of Exam
here. |
Roll No./OMR No |
Enter the Roll No./OMR No.* |
Score* |
Enter your score in Exam. |
Percentile* |
Enter your Percentile of exam. |
Family Details |
Name of Father* |
Enter your Father name. |
Occupation |
Select the occupation of your Parent / Guardian from the drop down. |
Office Address |
Specify the Current address of your Father. |
Phone Number* |
Specify their Office Telephone number preceeded with the STD code. |
Email |
Enter the email address of your Father. |
Name of Mother* |
Enter your Father name. |
Occupation |
Select the occupation of your Parent / Guardian from the drop down. |
Office Address |
Specify the Current address of your Father. |
Phone Number* |
Specify their Office Telephone number preceeded with the STD code. |
Email |
Enter the email address of your Father. |
Family Annual Income |
Enter the Family Annual Income. |
Educational Details |
X |
School Name |
Enter the name of the school you studied in. |
Board / University Name* |
Specify the Board / University. |
State* |
Enter the state. |
Year of Passing * |
Select the year of passing from the drop down. |
Percentage Scored * |
Enter your overall percentage. |
Main Subjects |
Enter your major subjects. |
Mode of Study* |
Select the mode of study from the drop down provided. |
XII |
School Name |
Enter the name of the school you studied in. |
Board / University Name* |
Specify the Board / University. |
State* |
Enter the state. |
Year of Passing * |
Mention the year in which you passed. |
Percentage Scored * |
Enter your overall percentage. |
Main Subjects |
Enter your major subjects. |
Mode of Study* |
Select the mode of study from the drop down provided. |
UG Degree |
Examination type * |
Select the relevant option. |
Name of degree * |
Enter your degree. |
College Name |
Enter the college you studied in. |
Board / University* |
Enter the Board or University. |
State* |
Enter the state. |
Year of Passing* |
Mention the year in which you passed. |
Major Subject / Discipline * |
Enter your major subjects. |
Mode of Study* |
Select the mode of study from the drop down provided. |
Total Aggregate % * |
Enter your overall percentage. |
PG Degree |
Do you have PG Degree * |
Select the relevent option. |
Type Of Degree * |
Select the relevant option from the drop down. |
Name of degree * |
Enter your degree. |
College Name |
Enter the college you studied in. |
Board / University |
Enter the Board or University. |
State |
Enter the state. |
Year of Passing |
Mention the year in which you passed. |
Major Subject / Discipline |
Enter your major subjects. |
Mode of Study |
Select the mode of study from the drop down provided. |
Total Aggregate % * |
1 Year (%/CGPA)* |
Enter your 1st year percentage. |
2nd Year (%/CGPA)* |
Enter your 2nd year percentage. |
Employment History |
Do you have Work Experience * |
Select the relevant option from the drop down. |
Name of the Organisation* |
Enter your Organisation Name. |
From Month/Year * |
Select the date when you joined the organisation. |
To Month/Year * |
Select the date till you worked in the organisation. |
Designation* |
Mention your designation in the organisation. |
Work experience in Months |
Specify your total experience in months. |
Other Details |
Academic interest and purpose of study * |
Not exceeding 1000 characters write about your academic interest and purpose of study. |
Please account for break in your academic career, if any * |
Not exceeding 1000 characters write about your account for break in your academic career, if any. |
Statement of Purpose (Please type in 200 words your reason for joining our PGDM Programme) * |
Enter Statement of Purpose (Please type in 200 words your reason for joining our PGDM Programme) |