Application for Admission in Management (B.COM/BBA/MBA/E-MBA) Programmes (Academic Year )

Transcription

1 dd /mm/y y _ Birla Institute of Technology, (Ranchi) India International Centre, Ras Al Khaimah, UAE Facilitated by CORE International Institute of Higher Education FZE,RAK Application No. Programme applied for: Application for Admission in Management (B.COM/BBA/MBA/E-MBA) Programmes (Academic Year ) Affix Recent Programme: (write sr. no. in the box) Colour 1. Bachelor of Business Administration (BBA) Passport Size Photo 2. Integrated MBA (BBA-MBA) 3. Masters of Business Administration (MBA) 4. Management Programme for Executives (E-MBA)-Weekend 5. Bachelor of Commerce (B.Com) (A) Personal Information Name of the Candidate: Father s Name: Mother s Name: Contact No s with STD code: (M) (R) ID: DOB: Gender: Male/ Female Nationality: Passport No.: Valid up

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3 Correspondence Address Permanent Address Emergency Contact No.( M) (R) (B) - Educational Details Total Aggregate Board / Name of Institute / Year of Sr No Course Marks Percentage University Passing Obtained / Grade 10 th Grade/O Level or 1 Equivalent Exam 12 th Grade or 2 Equivalent Exam Graduation 3 Degree 4 Any other If result is awaited, expected month of result: Medium of Instructions: Name of last school attended:

4 EMPLOYMENT DETAILS (Most Recent First- for MPE candidate and others if applicable): Sr. Name of the Organization Designation No of From To Annual No. years of Income experience INFORMATION ON CURRENT EMPLOYMENT: Place of work: (Location & City) Working hours: From to Weekend holidays: (Specify days) INFORMATION ON STUDENT VISA: 1. Student Visa Required: 2. If Hostel Accommodation is required: 3. If any of your parents is resident of UAE/GCC Country: (C) -Family Details A) Father s Name: Father s Occupation: Office Address: Contact No s with STD code: (M) (R) ID: Annual Income:

5 B) Mother s Name: Mother s Occupation: Office Address: Contact No s with STD code: (M) (R) ID: C) Local Guardian Name if any: Office/Residential Address: Contact No s with STD code: (M) (R) ID: Declaration by the Applicant: I hereby declare that, I have read all the Admission Instructions and shall abide by all conditions laid therein. I further hereby declare that all the information given and statements made in this application and also its accompanying attachments/ enclosures are true to the best of my knowledge. I agree to the condition that if any information or statement is found to be incorrect, my admission will automatically be cancelled. If Admitted, I promise to abide by the rules and regulations in force or those that may hereafter be made for the administration of the Institution and I shall do nothing either inside or outside the Institution which will interfere with its orderly working and discipline. In all matters concerning me and the Institution, its hostels, Practice, School stations, etc. the decision of the Competent Authority shall be binding on me. Place: Sign: Date: Name:

6 Declaration by Father/Mother or Guardian: I, do solemnly affirm that I shall be responsible for the discipline and conduct of my son/daughter/ward and pay regularly all his/her expenses during his/her stay in the Institute. Place: Date: Sign: Name: For Office Use Only Checklist of the documents to be submitted at the time of Admission Sr. No Details Documents Submitted 1 Date of Birth Certificate 2 10 th Grade/O Level Mark sheet 3 12 th Grade Mark sheet Graduation Degree Mark sheet (all 4 years) 5 Certificate of Nationality 6 Copy of Passport 7 Copy of VISA 8 Last College attended Leaving Certificate / Transfer Certificate 9 Medical fitness certificate issued by Registered Medical Practitioner Undertaking for submission of result 10 (if result is not declared at the time submission of form) 11 Experience Certificate 12 Any other Sr. No. Total No. of documents received. Sr. No. Total No. of documents not received. Total No. original documents are received. Checked by: Date:

7 Admitted / Not Admitted: Mr / Ms is admitted to 1 st year BBA/Integrated MBA /MBA /Management Programme for Executives (E-MBA) for the academic year Coordinator Admission Committee Sr. Manager Administration Director Details of fee payment: Payment made by Cheque /Draft Cheque/D.D No. Drawn on Date: Cash Bank Transfer Credit Card In case payment made in DD/Cheque, should be drawn in favour of CORE International Institute of Higher Education FZE payable at Ras Al Khaimah Name CORE International Institute of Higher Education FZE Bank Name : First Gulf Bank Currency Account No. IBAN Swift AED AE USD AE Fess particulars Amount in Receipt No. Date Accountant/ Remarks AED/USD Cashier Sign Admission fee Exam Fee Other fee

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