Application Form
Application Form
(Declared as Deemed-to-be University under Section 3 of the UGC Act, 1956 vide Notification No.F.937/2001-U-3 dated 13th January, 2003 of the Government of India)
______________________________________________________________________________
V. L. Mehta Road., Vile-Parle (W), Mumbai 400 056. Tel: +91 - 22-2613 4577 / 2618 3688 / 42355555
Fax: +91-22-26114512 Email: [email protected] Visit us at: www.nmims.edu
SCHOOL OF SCIENCE
APPLICATION FORM
Affix Recent
Passport size
colour
Photograph
A.1.
(B2 to B6 Mark
B.1.
or
AGE :
Yrs.
)
Months DATE OF BIRTH
D D
M M
Y Y
Y Y
(As on 31/05/2011)
B.2.
GENDER :
B.3.
B.4.
CATEGORY :
B.5
NATIONALITY : Indian
B.6
UNIVERSITY : Mumbai
C.1.
Examination
Bachelors Degree
Course (Please
Specify)*
1st Yr. I Sem
II Sem
2nd Yr. III Sem
IV Sem
3rd Yr. V Sem
VI Sem
4th Yr. VII Sem
Male
Open
Degree Awarded
Female
Unmarried
SC
ST
Others
OBC
____________
Other
University
/Board
Other
Month &
Year of
Passing
Marks
Obtai
ned
Out
of
Perce
ntage
Class/
Grade
VIII Sem
12th / IB Diploma
10th
* If Final Year Result is not declared write result awaited.
* Mention Major & Minor Subjects at under graduation/Degree
E.1. PROFESSIONAL /WORK EXPERIENCE:
Organization
Designation
Period
From
To
Brief
description of
the nature of
job
F: PERSONAL DETAILS
F.1.
F.2.
F.3.
Email : ________________________________________________________________________
Place : ________________
Date : _________________
________________________
Signature of the Candidate