Centre:_________________________________

Registration No.
(For office use only)

S.No. 55/2-7, Tathawade, Off Mumbai-Bangalore Bypass, Pune - 411 033 Tel.: 020-66741235 / 36 Fax : 020-66741234 Website : www.balajisociety.org Email : [email protected]

To The President, Sri Balaji Society, S.No. 55/2-7, Tathawade, Off Mumbai-Bangalore Bypass, Pune - 411 033.

Affix your recent self-attested coloured photograph

Sir,

COMMON APPLICATION FORM FOR ADMISSION TO TWO-YEAR FULL TIME POST GRADUATE DIPLOMA IN MANAGEMENT/ MBA PROGRAMS 2012-14 OFFERED BY THE MANAGEMENT INSTITUTES OF SRI BALAJI SOCIETY

I have gone through the prospectus of Sri Balaji Society and I am submitting my application for admission to the Management Programs offered by the Management Institutes of Sri Balaji Society mentioned below:-

Balaji Institute of Modern Management (BIMM) Balaji Institute of Telecom and Management (BITM) Balaji Institute of Management Studies (BIMS) NOIDA

Balaji Institute of International Business (BIIB) Balaji Institute of Management and Human Resource Development (BIMHRD ) Balaji Institute of Management Studies (BIMS) CHENNAI

Balaji Institute of Mass Communication (BIMC) PUNE GENERAL INFORMATION

Note: Please fill up the columns in Capital Letters only

1. Name of the Applicant :

(As per Matriculation or X Std. Certificate)

2. Date of Birth

:
DD MM YYYY

Age: _____ Years_____Months

(as on 1st June. 2012) (Tick Appropriately)

3. Sex 4. Nationality

: :

Male

Female

_______________________

5.

Religion :

_______________________

-26. Father's Name :

7. Father's Present Occupation : _____________________________________________________________ 8. If Father is employed his current status, Name & Address of the Organisation_______________________ ________________________________________________________________________________________ ________________________________________________________________________________________ 9. Telephone No. (including STD code) of Office :______________________________________________ 10. Telephone No. (including STD code) of Residence :___________________________________________ 11. Mobile No.:_______________________________________________ 12. If Married, Spouse Name & Occupation :____________________________________________________ ________________________________________________________________________________________ 13. Mother's Name :

14. Mother's Occupation : __________________________________________________________________ 15. (a) Family's Yearly Income :______________________________________________________________ (b) Sources of Income:__________________________________________________________________ 16. Do you have any Brother(s). If so, their present occupation :_____________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________

17. Do you have any Sister(s). If so, their present occupation :______________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________

-318.
PERMANENT ADDRESS (Compulsory) PRESENT ADDRESS FOR CORRESPONDENCE

City: State: Pin Code: Contact Details: (a) STD Code: (c) Mobile No: (d) E-mail* :

City: State: Pin Code: (b) Telephone Number:

* Furnishing of Email is mandatory.

If you are not in your Permanent Address state reasons for your being in the present address :
___________________________________________________________________________________________________ ___________________________________________________________________________________________________

19. Mother Tongue :______________________________________________________________________________

ACADEMIC PROFILE

20.
Academic Level School / College / Institution Board/University

Year of Completion

Degree

Final Grade / Marks in %

A B C D E F G

Std. X Std. XII Graduation 1st Yr Graduation 2nd Yr Graduation 3rd Yr Graduation 4th Yr Post Graduation Other Examinations (Please specify)
Course Title School / College / Institution Board/University Year of Completion Degree Final Grade / Marks in %

-421. (a) Specialization in 3 years Degree, if any_________________________________________________ (b)Specialization in 4 Years Degree (such as computer, mechanical and so on)_____________________ (c) Medium of Study up to 10th std.______________________________________________________ (d) Medium of Study up to 12th std.______________________________________________________ (e) Medium of Study up to Graduation____________________________________________________
Note : No original Degree/Diploma Certificate need to be attached at this stage. These are required to be produced at the time of GD and PI and will also be scrutinized by a committee on admission. Those students who are in the final year of Degree course should meet the eligibility criteria on the completion of the course. Those not meeting the eligibility criteria of the Institute will attract cancellation of admission.

22. (a) Are you from SC category :

Yes

No No

(b) If yes, are you attaching certificate from competent Govt. authorities to prove your caste. Yes

23. (a) Are you from ST category :

Yes

No No

(b) If yes, are you attaching certificate from competent Govt. authorities to prove your caste. Yes

24. (a) Are you from OBC category :

Yes

No No

(b) If yes, are you attaching certificate from competent Govt. authorities to prove your caste. Yes

25. (a) Are you a physically handicapped candidate : Yes

No Yes No

(b) If yes, are you attaching disability certificate from competent authorities.

26. (a) Are you an Industry sponsored candidate :

Yes

No

(b) If yes, attach copy of sponsoring company's letter signed by the Corporate Director HR of the Company.

27. (a) Are you an outstanding performer in Academics (Medalist or Rank Holder) in the University
Yes (b) If yes, are you attaching supporting document signed by competent authorities No

28. Are you a candidate for Management quota? 29. (a) Have you passed your Bachelor's degree from a recognized University? :
(b) Are you studying in the final year of Bachelor's Degree now? :

Yes Yes Yes Yes

No No No No

30. (a) Did you pass any course as a private/external/distance learning mode student?

(b) If yes, name the course(s)_____________________________________________________________

31. (a) Did you have any gap in your continued education.

Yes

No

(b) If yes, state reasons for the same________________________________________________________

-5FULL -TIME INDUSTRY WORK EXPERIENCE IF ANY

32. A must for Executive Batch. Others can also fill up this part. Only those with full-time job experience undertaken in
progress after graduation and through a valid appointment order of a statutory company with proper terms and conditions including salary and job profile such as sales, marketing, human resources, operations, finance and Information Technology and so on will be the qualifying work experience. All relevant documents should be produced during the interviews and the selection committee will decide whether to accept the same or not.

Sr. No.

Position Held (Designation) Nature of Work

Duration Total Total Pay Name of Organization From To year/month (Rs./Month) with Address (mm/yy) (mm/yy)

-6MANAGEMENT PROGRAMMES OFFERED BY SRI BALAJI SOCIETY Two Year Full Time Job oriented PGDM Programmes offered by BIMHRD
1. POST GRADUATE DIPLOMA IN MANAGEMENT (PGDM) Specializations Offered: Sales and Marketing (including Retail and Insurance), Finance and financial services, Operations and Supply Chain Management including Logistics and Systems. 2. POST GRADUATE DIPLOMA IN MANAGEMENT(PGDM-Marketing & Finance) a) It is a full-fledged two year full time program with focused specialization in Marketing or Finance. b) Specialization will be offered in two disciplines to two groups of students. Means, about 30 students can specialize in Marketing and 30 students may specialize in Finance. 3. POST GRADUATE DIPLOMA IN MANAGEMENT (PGDM-PM & HRD) a) It is a specialist program in Personnel Management & Human Resources Development including Labour Laws offering excellent scope in the sphere of Human Resources Management in the industry. b) 50% of the seats are reserved for Engineers.

Two Year Full Time Job oriented PGDM Programmes offered by BIIB
4. POST GRADUATE DIPLOMA IN MANAGEMENT (PGDM-International Business) a) It is a full fledged two years full fledged Management program with extensive exposure and specialisation in International Business drawn on the lines of Indian Institute of Foreign Trade (IIFT). b) Students of this course can get placed in the field of International Business as well as Marketing in the Industry. 5. POST GRADUATE DIPLOMA IN MANAGEMENT (PGDM-Marketing) It is a full fledged two years full fledged Management program with extensive exposure in th field of Sales & Marketing with an overview of International Business. 6. POST GRADUATE DIPLOMA IN MANAGEMENT (PGDM-Finance) a) It is a full fledged two years full time program with specialisation offered in Finance. b) Selected students from this course can also specialise in SAP (FICO) Model and can get placed as SAP consultants which has the potential of global careers.

Two Year Full Time Job oriented PGDM Programmes offered by BITM
7. POST GRADUATE DIPLOMA IN MANAGEMENT (PGDM-Telecom) a) It is a full-fledged two year full time program with specialization in Telecom Management, Systems, Operations and finance. b) Only Engineers with specialization in Electronics and Telecommunications/ Telecommunications / Computer Science/ Information Technology/ Instrumentation/ Electrical are eligible for Telecom Specialisation. However Engineers from all streams are eligible to apply for Systems and Operations. 8. POST GRADUATE DIPLOMA IN MANAGEMENT (PGDM Telecom & Marketing) a) It is a full-fledged two year full time program with focused specialization in Telecom Management as well as Marketing. Means, about 30 students can specialize in Telecom and 30 students can specialize in Marketing. b) Eligibility For Telecom Specialization. Same as per serial 1 above. c) Eligibility for Marketing. Same as per serial no.9. 9. POST GRADUATE DIPLOMA IN MANAGEMENT (PGDM-Marketing & Finance) a) It is full-fledged two year full time program with focused specialization in Marketing or Finance. b) Specialization will be offered in two disciplines to two groups of students. Means, about 30 students can specialize in Marketing and 30 students may specialize in Finance. Any bright graduate is eligible to apply for this course

-7Two Year Full Time Job oriented PGDM Programmes offered by BIMM
10. POST GRADUATE DIPLOMA IN MANAGEMENT (PGDM) Specializations Offered: Sales and Marketing (including Retail and Insurance), Finance and financial services, Systems, Operations and Supply Chain Management including Logistics. 11. POST GRADUATE DIPLOMA IN MANAGEMENT (PGDM-IT & Marketing) a) A full fledged program offering specialization in Systems as well as Sales and Marketing Management. b) SAP Training- S&D Module and ABAP will also be offered at a nominal fee, to be charged additionally, to selected students enhancing chances of placements as SAP consultants. (This training is a very expensive one if sought outside.) c) Only Engineers are eligible to take admission in this course. 12. POST GRADUATE DIPLOMA IN MANAGEMENT (PGDM-PM & HRD) a) It is a specialist program in Personnel Management & Human Resources Development including Labour Laws offering excellent scope in the sphere of Human Resources Management in the industry. b) 50% of the seats are reserved for Engineers. ELIGIBILITY
Candidates should have a minimum of 50% marks in graduation from any statutory University (45% for reserved category). However bonus marks will be given to relevant full time industrial experience and higher percentage of marks. Those who are in their final year of graduation in the academic year 2011-12 and are confident to get 50% can also apply and furnish evidence of degree by 1/11/2012.

Two Year Full Time Job oriented PGDM (Executive) Programmes offered by BIMM
13. POST GRADUATE DIPLOMA IN MANAGEMENT (PGDM-Executive) a) Scope- Those with adequate and appropriate industry experience will be admitted to this batch and presented for lateral placements with higher salary as compared to others as we hope them to be placed at higher level. b) Eligibility- Candidates should have a minimum of 50% marks in graduation from any statutory University and 3 to 5 years of managerial/supervisory experience is essential. However bonus marks will be given to relevant full time industrial experience and higher percent of marks. c) Specializations Offered: Sales and Marketing (including Retail and Insurance),Finance and financial services, HR, Systems, Operations and Supply Chain Management including Logistics.

14. Two Year Full Time Job oriented, face-to-face, on Campus MBA Programme offered by BIMS, Noida in Collaboration with Centre for Corporate Education, Training & Consultancy IGNOU (Central University) a) Specializations Offered: Sales and Marketing, Finance, HR, Operations Management. b) Eligibility- Candidates should have a minimum of 50% marks in graduation from any statutory University as per IGNOU.

15. Two Year Full Time Job oriented, face-to-face, on Campus MBA Programme offered by BIMS, Chennai in Collaboration with Centre for Corporate Education, Training & Consultancy IGNOU (Central University) a) Specializations Offered: Sales and Marketing, Finance, HR, Operations Management. b) Eligibility- Candidates should have a minimum of 50% marks in graduation from any statutory University as per IGNOU.

-8MANAGEMENT COURSES APPLIED FOR BY THE CANDIDATE 33. A student can opt for any one, or more or for all the courses of any Institute or all the Institute. The name of courses are
mentioned below. Proper Completion of the Column(s) will enable the selection committee to assess your suitability and consider your case for any one of the courses. The order of preference/priority of each course should be mentioned against preference code as 01, 02, 03 and so on upto 15 as fifteen courses are offered.

Sr. No.

Course Title & Institute Name

Preference Code

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 34.

PGDM offered by BIMHRD PGDM (Marketing and Finance) offered by BIMHRD PGDM (PM&HRD) offered by BIMHRD PGDM (International Business) offered by BIIB PGDM (Marketing) offered by BIIB PGDM (Finance) offered by BIIB PGDM (Telecom) offered by BITM PGDM (Telecom & Marketing) offered by BITM PGDM (Marketing & Finance) offered by BITM PGDM (Freshers) offered by BIMM PGDM (IT & Marketing) offered by BIMM PGDM (PM&HRD) offered by BIMM PGDM (Executive Batch) offered by BIMM MBA (face -to-face, on Campus) offered by BIMS, Noida
In Collaboration with Indira Gandhi National Open University (IGNOU) Eligibility is 50% in Graduation

MBA (face -to-face, on Campus) offered by BIMS, Chennai

In Collaboration with Indira Gandhi National Open University (IGNOU) Eligibility is 50% in Graduation

MA in Journalism & Mass Communication offered by BIMC, Pune

Affiliated to University of Pune

ENTRANCE EXAM DETAILS CAT MAT

Roll No. Date Percentile

CMAT
Test Center Code Test Regn. No. Percentile

Test Center Code Test Regn. No. Percentile

The candidate can submit the application form without the CAT/MAT/CMAT scores. They can submit the print copy of their score card when the results are declared, as we will declare the merit list after GD and PI which will be held after the declaration of CAT 2011 results. It may be noted that we are not going to do our short listing based on the CAT/MAT/CMAT score alone, although weightage is alloted for the same.

-9CENTRES FOR GROUP DISCUSSION AND PERSONAL INTERVIEW

35. While we are keen to have the admission process in all the centres mentioned below and have been having many of the centres for many years in the past, we reserve the right to cancel any of the centres depending upon the contingencies. However, it may be noted that, the hall ticket issued by us to any centre is valid to all the centres and the students who may need a change of centre due to any reason can automatically go to any other centre by just informing us through an email/fax and without expecting any response to the same. Changes in dates, if any, for the Group Discussion, Essay writing and Interviews will be available on our website on as required basis. Students are therefore advised to see the website regularly.

Centre Name Ahmedabad Bangalore Bhopal Bhubaneshwar Chandigarh Dehradun Delhi Hyderabad

Centre Code 01 02 03 04 05 07 08 09

Centre Name Kolkata Lucknow Mumbai Nagpur Patna Pune Raipur Ranchi Noida Guwahati

Centre Code 14 15 16 17 18 19 20 21 22 23

Indore Jaipur
Kochi

10 11
13

Choice of Selection Centre (GD & PI): Preference 1 ___________________________ Centre Code :

Preference 2 ___________________________ Centre Code :

Preference 3 ___________________________ Centre Code :

-10EXTRA-CURRICULAR ACTIVITIES 36. This is not a compulsory part. Only those claims which can be substantiated with legitimate certificates need to be
mentioned here. Attach separate sheet if required. List not more than three significant achievements in extra-curricular activities.

S. No.

Achievements

Level

Year

What personal traits/qualities do you believe were instrumental in this achievement?

37. HOBBIES & INTERESTS ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________

38. Your source of information about our Courses : (Please tick wherever applicable)
a) Newspaper advertisements Yes No

If Yes, specify the name of the Newspaper : _______________________________________________________ b) Magazine Yes No

If Yes, specify the name of the Magazine : ________________________________________________________ c) Internet d) Alumni e) Current Students f) Parental Reference Yes Yes Yes Yes No No No No

g) Any other source : ___________________________________________________________________________ ____________________________________________________________________________________________

-11-

39. I am enclosing a Bank Draft of

1,050/- (Rupees One Thousand Fifty Only) bearing number____________________

Dated______/______/__________of Bank__________________________________________________________ on account of Registration fee in favour of 'President, Sri Balaji Society, Pune' payable at Pune.

CERTIFICATE OF UNDERTAKING 1. I declare that the information given by me in this application is true to the best of my knowledge. 2. I hereby undertake to abide by the instructions contained in the institute website and all the disciplinary rules of the Institute and authorize the Director to initiate any suitable action, in case I infringe the rules and regulations as laid down by the institute. 3. I have carefully read and understood the rules and instructions regarding the refund of fees mentioned in the institute website and I hereby undertake to abide by the same. 4. Application form/ Registration Fee is not refundable. 5. I hereby declare that I am medically fit in all respects and I undertake to maintain more than the expected attendance. 6. I agree to abide by any government regulations regarding admissions if implemented by Sri Balaji Society. 7. I undertake that I will regularly attend the classes even after the campus placements. 8. Any dispute will be settled by arbitration, subject to the jurisdiction of Pune.

Date :

(Signature of the applicant)

Registration No.
(For office use only)

S.No. 55/2-7, Tathawade, Off Mumbai-Bangalore Bypass, Pune - 411 033 Tel.: 020-66741235 / 36 Fax : 020-66741234 Website : www.balajisociety.org Email : [email protected]

ADMIT CARD 2012-14

TO BE COMPLETED BY THE APPLICANT Name:_______________________________________________________________

(As in the application form)
Affix your recent self-attested coloured photograph

Address:_____________________________________________________________ ____________________________________________________________________ __________________________________________Pin Code: Centre applied for Group Discussion & Personal interview:________________________________________ SIGNATURE OF THE APPLICANT
Please sign here and send along with Application Form To be signed at the time of Personal Interview

TO BE COMPLETED BY THE OFFICE

CENTRE:_______________________________________________________________________________________ DATE OF SELECTION PROCEDURE :______________________________________________________________ REPORTING TIME :______________________________________________________________________________ POSTAL ADDRESS OF THE GD AND PI CENTRE :___________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________

Seal

Signature