International School of Business and Media 

                                           ONLINE APPLICATION FOR ADMISSION

                              POST GRADUATE PROGRAMME & BATCH (2012-2014) 

I wish to apply for the following course in the academic year 2012-2014:   

  ( * Marked Fields are Compulsory) 

SECTION A

 * Choice of Programme: 

(Note: Supply Chain & Operation Management  is for Engineering Graduates only) 

 Choice of Entrance Exam Centre:

                         * Choice 1:                 

                         * Choice 2:                 

                         * Choice 3:                

 * Choice of G.D. & P.I. Centre: 

                                                            

  XAT Identification Number: 

       (Attach Photocopy of Score Card)

  CAT Identification Number: 

       (Attach Photocopy of Score Card)

  SECTION B: PERSONAL INFORMATION:

* First Name:
* Surname:
* Father's / Guardian's Name:
Mother's Name:
Professional Background of Parent / Guardian:

* Date of Birth:  * Date:        * Month:         * Year:    

Blood Group:         Height ( in Cm.):          Weight (in Kg):          

Nationality: 

Any Major Ailment or Continuing Health Problem:

 CONTACT INFORMATION:

* Present Address: 

* City / Village: Post Office:
* State: * Pin Code:
* Tel No. (With STD Code):
* Mobile:
* E Mail:

* Permanent Address:

* City / Village: Post Office:
* State: * Pin Code:
* Tel No. (With STD Code):
* Mobile:
* E Mail:

SECTION C: EDUCATIONAL BACKGROUND: ( First Row is Compulsory )

 ( If appearing for final year, mention aggregate marks of 1st & 2nd. )

IMPORTANT: In Marks do not enter % sign, only enter number (ex: 50.5)

Course Univ/Board Institute Year of Passing Subjects Marks(%) Class / Grade
Std. 10
Std. 12
Others:

 SECTION D: WORK EXPERIENCE

 (Will be required to furnish proof of working / experience certificate)

Sr No. Company From

(mm/dd/yy)

 To

(mm/dd/yy)

 Position Held / KRAs

Location
     1
     2

What are your career growth expectations:

 

SECTION E: GENERAL

ABOUT ISB&M:

How did you hear about ISB&M ? 

    Print Media          Friends         Coaching Centre           Other Sources

Why do you think ISB&M is the best option ?
CAREER GOALS:
What are your long term objectives in life ?
Where do you see yourself five years from now  ? 
Mention your Strengths and Weaknesses: 
What qualities do you have which will make you a committed and responsible  professional in corporate field? 

SECTION F: PAYMENT DETAILS: 

   Enter Payment Mode:

               

   If your Payment Mode is By Demand Draft, Enter Demand Draft Details:

Demand Draft No.:
Drawn on (Bank):
Demand Draft Date (mm/dd/yyyy):

 Admission Form Number (Type NA for Online application):

   UNDERTAKING:

1)  I hereby submit to the jurisdiction of the Pune court in the event of any dispute. I have carefully noted the rules and process of admission as given in the prospectus which I am required to follow and shall in matters of interpretation, accept the decision given by the Director in this respect as final and binding.
2)  I shall conduct myself as per the rules and norms of ISB&M, failing which I shall not approach the Director for any concession in this regard and shall be liable to be debarred from the Institute. Manual of Policies will be provided at the time of admission.

3) I have also read, understood and accepted the code and conduct of the Institute and shall take note of all communication put from time to time.

                                      I Agree                I Disagree