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Application Form

The document is an admission form for Pioneer Institute of Management's full-time MBA program for the 2011-2012 batch. It provides fields for applicants to enter their personal details like name, father's name, mailing and permanent addresses, email, mobile number, gender, marital status, and date of birth. It also has a section for applicants to provide details of their last educational qualification including the name of the institution, year of passing, subject, and grade or division obtained. At the end, it requires signatures of the applicant and their father along with the date and includes a declaration that all information provided is true.
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0% found this document useful (0 votes)
46 views

Application Form

The document is an admission form for Pioneer Institute of Management's full-time MBA program for the 2011-2012 batch. It provides fields for applicants to enter their personal details like name, father's name, mailing and permanent addresses, email, mobile number, gender, marital status, and date of birth. It also has a section for applicants to provide details of their last educational qualification including the name of the institution, year of passing, subject, and grade or division obtained. At the end, it requires signatures of the applicant and their father along with the date and includes a declaration that all information provided is true.
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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PIONEER INSTITUE OF MANAGEMENT

(A.I.C.T.E. & Ministry Of HRD APPROVED, Affiliated to RTU, KOTA)


Pioneer Valley, (Airport Road) Debari ,Udaipur (Rajasthan)
Ph: 0294-3204755/ 3204756 E-mail:[email protected]
www.pioneerinstitute.in

Admission Form: (Batch 2011-12 )


M.B.A. (Full Time)
Specializations Offered:
HR
Marketing
Finance
Production & Operation
Information Technology
Tourism & Hotel Management
1. Name:
_____________________________
(Full Name In Block Letters)

2. Father Name:
_____________________________
(Full Name In Block Letters)

2. Mailing address:
__________________________________________________________________
________________________________________________________________
3. Permanent address:
_______________________________________________________________
_______________________________________________________________

5. E-mail:
______________________
7. Gender: Male

6. Mobile:
_____________

Female

Res. Tel.:

8. Marital Status: Single

_______________
Married

9. Date of Birth: _________ /________ /________


(Day)
(Month)
(Year)

Last Education Qualification

Name Of The
Institution

Year

Subject

Grade/
Division

Declaration: I hear by declare that all the information given above is true to the best of
my knowledge. If anything is found to be incorrect I would be solely responsible for the
same.

______________
__
Applicant signature

______________
__
Fathers Signature

________________
Date

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