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Atal Bihari Vajpayee - Indian Institute of Information Technology & Management Gwalior

This document is an application form for the MBA-IT Enabled Services Management program at the Atal Bihari Vajpayee Indian Institute of Information Technology and Management Gwalior. The 3-page form requests information such as personal details, educational qualifications, work experience, and test scores. It includes a checklist of required documents and an undertaking by the applicant agreeing to abide by the institute's rules.

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SachinSharma
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62 views2 pages

Atal Bihari Vajpayee - Indian Institute of Information Technology & Management Gwalior

This document is an application form for the MBA-IT Enabled Services Management program at the Atal Bihari Vajpayee Indian Institute of Information Technology and Management Gwalior. The 3-page form requests information such as personal details, educational qualifications, work experience, and test scores. It includes a checklist of required documents and an undertaking by the applicant agreeing to abide by the institute's rules.

Uploaded by

SachinSharma
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd
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ATAL BIHARI VAJPAYEE


INDIAN INSTITUTE OF INFORMATION TECHNOLOGY & MANAGEMENT
GWALIOR
(AN AUTONOMOUS INSTITUTE OF GOVT. OF INDIA)
Application
Form for Management
Programmes
Website:
www.iiitm.ac.in
(MBA-IT Enabled Services Management)
Fill relevant details of valid all India level proficiency scores (as applicable) *
CAT Registration No.
CAT Percentile/score
CMAT Registration No.
CMAT Percentile/score
MAT Registration No.
MAT Percentile/score

Paste Your
Recent
Photograph

* Please attach an attested copy of score.

Choice of Centre (for group discussion and personal interview of short listed applicants, however
Institute has discretion to change the centre)
Gwalior
New Delhi

Applicants Information (Fill relevant details or tick appropriately)


1
Name of Applicant
2
Sex
Male
3
Date of Birth
DD/ MM /YYYY
4
Category
SC
ST
5
Fathers/Mothers/Guardian Name
6
Address for Correspondence

Female
PH

OBC

General

City
PIN
State
7
8
9
10.

E-Mail
Mobile Phone
Online Fees
Transaction ID Number
Date

DD/ MM /YYYY

Educational Qualifications (Please check your eligibility as per admission notice and indicate your degree clearly)
# Examination
Board / University
Year of
% of Marks / Discipline
Mathematics /
Passing
CGPA
Statistics as a Subject
(yes/no)
1 SSC (10th)
2 HSC(12th)
3 Bachelors
4 Masters
5 Others (Specify)

Work Experience
#
Name of Organization

Post Held

Job Description

Duration

One set of attested/self attested photocopy of all the supportive documents as given in below check list must be
attached along with hard copy of completely filled-in/typed application form.
Check-List
a
Mark-sheet of all examinations passed (where grades are awarded the equivalent
of the grades and the corresponding percentage duly countersigned by the
Concern Authorities of the Institution / University should accompany Grade
Cards.)
b
Conversion formula if results were in the form of Grades/CGPA
c
Valid CAT/CMAT/MAT Score
d
Proof of Date of Birth
e
SC/ST/OBC (non creamy layer) /PH Certificate
f
Online Fees Transaction ID receipt

Yes

No

Yes
Yes
Yes
Yes
Yes

No
No
No
No
No

NOTE: Your application will not be considered if not accompanied by appropriate certificates and documents
or received after the last date of submission.
UNDERTAKING BY THE CANDIDATE
a)

I hereby certify that the foregoing particulars are correct and I agree that admission may be granted to me on
the terms, conditions and rules of the ABV-IIITM Gwalior or such modifications thereof as may be made by
authorities concerned from time to time. I understand that my admission may be cancelled and tuition fee
paid by me forfeited if any of the particulars given by me in this application form are subsequently found to
be wrong.
b) I agree that the institute decision in all matters concerning my admission, studies, discipline and conduct will
be final and binding on me.
c) On admission, I undertake to submit myself to the disciplinary jurisdiction of the institute according to the
rules of the institute.
d) I understand that my association, active or passive, with any unlawful organization is forbidden.
e) I certify that I am not registered as a provisional or otherwise student of any other institute.

Place: .

Signature of the Applicant

Date: ..

Name:

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