Scribd Logo
Upload

Welcome to Scribd!

  • 16 views

    Application Form Application Form: Gateway Toa Bright Career....

    Uploaded by

    Ankit Tiwari
    This document is an application form for Shriram Institute of Management & Technology. It provides instructions for applicants and collects personal details such as name, gender, date of birth, address, education history, and other relevant information. It also lists the academic programs offered, including MBA, BBA, BCom, BCA and BEd. The form notes the application process and requirements, including submitting documents, transcripts and fees. It also outlines rules regarding admission, conduct, and the institution's right to change policies.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Application Form Application Form: Gateway Toa Bright Career....

    Uploaded by

    Ankit Tiwari
    16 views4 pages
    This document is an application form for Shriram Institute of Management & Technology. It provides instructions for applicants and collects personal details such as name, gender, date of birth, address, education history, and other relevant information. It also lists the academic programs offered, including MBA, BBA, BCom, BCA and BEd. The form notes the application process and requirements, including submitting documents, transcripts and fees. It also outlines rules regarding admission, conduct, and the institution's right to change policies.

    Original Description:

    App

    Original Title

    Application Form

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document is an application form for Shriram Institute of Management & Technology. It provides instructions for applicants and collects personal details such as name, gender, date of birth, address, education history, and other relevant information. It also lists the academic programs offered, including MBA, BBA, BCom, BCA and BEd. The form notes the application process and requirements, including submitting documents, transcripts and fees. It also outlines rules regarding admission, conduct, and the institution's right to change policies.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    16 views4 pages

    Application Form Application Form: Gateway Toa Bright Career....

    Uploaded by

    Ankit Tiwari
    This document is an application form for Shriram Institute of Management & Technology. It provides instructions for applicants and collects personal details such as name, gender, date of birth, address, education history, and other relevant information. It also lists the academic programs offered, including MBA, BBA, BCom, BCA and BEd. The form notes the application process and requirements, including submitting documents, transcripts and fees. It also outlines rules regarding admission, conduct, and the institution's right to change policies.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 4

    SHRIRAM INSTITUTE

    OF MANAGEMENT & TECHNOLOGY


    Accredited ‘B(Good)’ (Edu) by NAAC
    Approved by AICTE & NCTE Min. Of HRD, Govt. Of Uttarakhand
    Affiliated to Uttarakhand Technical University, Dehradun & Kumaun University, Nainital

    APPLICATION FORM

    Gateway
    to A
    Bright Career.....

    .....Building Values
    Shriram Institute of Management & Technology
    (A unit of Social Welfare & Education Society)
    7th km Stone, Ramnagar Road, Kashipur - 244713 (Uttarakhand)

    Academic Interests Application Number


    Choice of Course (Please tick one)

    Master of Business Administration (MBA)


    Bachelor of Business Administration (BBA)
    Bachelor of Commerce with Honours (BCom Hons)
    Bachelor in Computer Applications (BCA)
    Bachelor of Education (BEd)

    Instructions

    1. Applicants are requested to carefully go through the conditions mentioned in the prospectus before they
    fill in their applications.
    2. The application for admission should be accompanied by a Demand Draft, A/c payee, in favour of
    “Shriram Institute of Management & Technology” payable at Kashipur for an amount as per the
    prescribed fees by SIMT.
    3. Attach two copies of recent passport size coloured photographs of the candidate.
    4. Attach copies of the mark sheets/ certificates, etc., wherever necessary; originals should not be attached
    with application
    5. Attach additional sheet/s, if the space provided for information is inadequate

    Personal Details
    Name _________________________________________________________________
    (In capital letters) FIRST NAME MIDDLE NAME SURNAME

    Gender Male Female Nationality _________________________

    Date of Birth
    D D M M Y Y Y Y

    Father’s Name _________________________________________________________________


    FIRST NAME MIDDLE NAME SURNAME

    Mother’s Name _________________________________________________________________


    FIRST NAME MIDDLE NAME SURNAME

    Marital Status (Married/Unmarried) ______________________________________________________

    If Married, Give Husband’s Name (In case of Female Candidate) ________________________________________

    Father’s/Husband’s Occupation _________________________________________________________

    Group/Category (Attach Caste Certificate) _______________________________________________________

    Father’s/Guardian’s Mobile no. _______________________________________________________

    Father’s/Guardian’s Signature _______________________________________________________

    Any Criminal Record/Any Criminal case in Court? __________________________________________


    Address for Correspondence ____________________________________________________________

    ___________________________________________________________________________________

    ___________________________________________________________________________________
    CITY PIN STATE COUNTRY

    Phone/Mobile No. _______________________________ E-mail ______________________________


    (Include area code)

    Permanent Address ___________________________________________________________________

    ___________________________________________________________________________________

    ___________________________________________________________________________________
    CITY PIN STATE COUNTRY

    Phone/Mobile No. _______________________________ E-mail ______________________________


    (Include area code)

    Educational Qualifications
    Level Course e.g., BSc/ Board/University Institution Year Aggregate
    BCom/BBA, etc. From To %
    th
    10 Standard
    12th Standard
    Graduation
    Post Graduation
    Others

    Awards and Honour (Attach Certificates)


    ___________________________________________________________________________________
    ___________________________________________________________________________________

    Interest, Hobbies and Language Known (Attach Certificates)


    ___________________________________________________________________________________
    ___________________________________________________________________________________

    Application Fee Payment Details


    Demand Draft No. ____________________________________ Dated __________________________
    Drawn on Bank ____________________________________________________________________
    Amount (r) ____________________________________________________________________
    Details of Documents Attached
    th th
    10 Mark sheet & certificate 12 Mark sheet & certificate
    Graduation Mark sheet & certificate Transfer certificate
    Character certificate Caste Certificate
    Domicile certificate Income certificate
    Others certificates regarding co-curricular activities Bus Application Form
    Affidavit required in case there is gap after last exam Book Bank Form
    Affidavit required in case you passed last exam as private Insurance Form
    Rules and Regulations
    1. Misleading information or misrepresenting facts will disqualify the applicant from admission to SIMT
    th th
    2. Candidates must submit their 10 standard/ 12 standard/ Degree marks cards and certificates in original
    at the time of admission. Admission may not be given in absence of these documents.
    3. Payment of fees must be made by the prescribed date, failing which the admission will be forfeited.
    4. Application / tuition fee is not refundable or transferable under any circumstances.
    5. Candidates appearing for the qualifying exams must submit their proof of passing the qualifying exam
    within 3 months of starting of the session.
    6. The candidates must fulfill all the academic requirements notified by the authorities from time to time.
    7. SIMT has full discretionary powers to alter the admission process, Code of Conduct, Rules &
    Regulations without prior notice and without assigning any reason.

    Declaration
    I certify that all the information furnished above is complete and correct to the best of my knowledge. I agree to abide by
    all rules and regulations that are in force time to time in the Institute. I understand that withholding or giving false information
    will make me ineligible for admission. I also understand that the application fee and tuition fee paid to SIMT are not refundable
    under any circumstances. Further, I have read and understood all the Rules & Regulations for admission to courses in SIMT. I
    undertake that I will strictly follow the Code of Conduct, Rules & Regulations issued by the Management/K.U./Authorized body.

    Signature of the Applicant

    I certify that the aforesaid is true and if found false, I shall be held responsible for it.

    Date: Signature of Father's/Guardian

    For Office Use Only (Application)


    Application received on _________________________
    Receipt No. ________________________ Registration No. ________________________
    Remarks _______________________________________________________________
    _______________________________________________________________
    Application Verified by ________________________ Date _________________________________

    Signature of Fin. & Acc. Signature of Office Executive


    For Office Use Only (Admission Details)
    Application No. _______________________________________________________________
    Receipt No. _______________________________________________________________
    Course to which admitted _______________________________________________________________
    Hostel _______________________________________________________________
    Recommendation of the admission Committee ______________________________________________
    ___________________________________________________________________________________

    Date Signature of Convener

    CAMPUS: 7TH KM STONE, RAMNAGAR ROAD, KASHIPUR-244713, UTTARAKHAND


    Ph: (05947) 223190, 223032, 9927010999 Email: [email protected], Web: www.shriraminstitute.com

    You might also like