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    Mba Mca

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    Stallin Raghav
    This document is an application form for admission to MBA/MCA degree programs at Coimbatore Institute of Management and Technology. It requests basic personal details from the applicant such as name, address, date of birth, community, citizenship, qualifying examination details, extracurricular activities, and parent/guardian details including occupation and annual income. The applicant needs to declare that all information provided is correct and agrees to abide by the college rules.

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    Mba Mca

    Uploaded by

    Stallin Raghav
    30 views2 pages
    This document is an application form for admission to MBA/MCA degree programs at Coimbatore Institute of Management and Technology. It requests basic personal details from the applicant such as name, address, date of birth, community, citizenship, qualifying examination details, extracurricular activities, and parent/guardian details including occupation and annual income. The applicant needs to declare that all information provided is correct and agrees to abide by the college rules.

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    mba_mca

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    This document is an application form for admission to MBA/MCA degree programs at Coimbatore Institute of Management and Technology. It requests basic personal details from the applicant such as name, address, date of birth, community, citizenship, qualifying examination details, extracurricular activities, and parent/guardian details including occupation and annual income. The applicant needs to declare that all information provided is correct and agrees to abide by the college rules.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    30 views2 pages

    Mba Mca

    Uploaded by

    Stallin Raghav
    This document is an application form for admission to MBA/MCA degree programs at Coimbatore Institute of Management and Technology. It requests basic personal details from the applicant such as name, address, date of birth, community, citizenship, qualifying examination details, extracurricular activities, and parent/guardian details including occupation and annual income. The applicant needs to declare that all information provided is correct and agrees to abide by the college rules.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    MBA    MCA  Application No.

    COIMBATORE INSTITUTE OF MANAGEMENT  AND TECHNOLOGY 
    (Approved by AICTE, Ministry of HRD, New Delhi) 
    (Affiliated to Bharathiar University, Coimbatore) 
    Narasipuram Post, Thondamuthur Via., Coimbatore – 641 109. 
    Phone : (0422) 2650131, 2650132,   Fax : (0422) – 2650427 
    (An ISO­9001­2000 Certified Institution) 

    APPLICATION FORM FOR ADMISSION TO MBA/MCA  DEGREE COURSE 

    1. Name  :  Space for affixing 
    (in block letters with initials at the end)  Passport size 
    photograph
    Address for Communication  : 

    Pin Code  Ph. No.  STD Code 


    E­mail if any 

    2. Sex (3 )  :  Male  Female 

    3. Date of Birth  :  Date  Month  Year 

    Age (Completed Years)  : 
    Place of Birth  : 
    Village/Town/City  District               State 

    4. Community (3)  :     ST           SC      MBC/DNT     BC           FC 

    5. Are you a Citizen of India? (3)  :  Yes  No 

    6. Mother Tongue  : 
    7. Qualifying Examination 
    Name of the  Month/year 
    Institution / University  Duration  % of Marks 
    Degree  Passing 

    (Enclose only attested true copies of mark sheets. At the time of admission original certificates should be furnished) 

    8. Extra Curricular activities  : 

    9. Particulars regarding Parent / Guardian  : 
    a.  Name and Residential Address  : 

    Pin Code  Phone No.  STD Code 

    b. Occupation and Office Address  : 

    Pin Code  Phone No.  STD Code 

    c. Annual Income  :  Rs. 

    I declare that all the information stated above are correct and true to the best of my knowledge. I agree to be 
    governed by the rules & regulations of the college as in force and as may be revised from time to time. 

    Place  : 
    Date   :  Signature of the Applicant 

    Payment Details 

    Receipt No.    :  Date  :  Mode of Payment  : DD / CASH 


    DD No. / Date :  Bank / Branch  Amount:

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