DON BOSCO INSTITUTE OF MANAGEMENT

JOYPUR, KHARGHULI, GUWAHATI, ASSAM – 781004

FORM NO.

MBA APPLICATION FORM 2025

INSTRUCTIONS
1. Please read the instructions in the Prospectus before filling the form. Affix your latest
2. Use BLACK BALL POINT PEN in boxes using English capital letters or English numerals. passport
3. Do not make any stray marks on the sheet. size photograph
4. Do not staple, pin, wrinkle scribble, tear or wet this sheet. (4 cm x 5 cm) duly self-
5. Write in CAPITAL LETTERS only within the box without touching the lines as shown in the sample below. attested
0 1 2 3 4 5 6 7 8 9 A B C D E F G H

I J K L M N O P Q R S T U V W X Y Z

1. Name of the Candidate (Leave one box empty between First Name, Middle Name and Surname)

2. Sex 3. Date of Birth 4. Marital Status

(Write the relevant Date Month Year (Write the relevant

code in the box) code in the box)
S1 – Male M1 – Single
S2 – Female M2 - Married

4. Category 5. Nationality 6. Religion

(Write the relevant (Write the relevant (Write the relevant
code in the box) code in the box) code in the box)
C1 – Gen, C3 - ST N1 – Indian R1 – Christian (Catholic)
C2 – SC, C4 - OBC N2 – Others R 2 – Christian (Non-Catholic)
R 3 – Hindu, R4- Muslims, R5 - Others

7. Name of Father/Mother/Husband/Guardian/Sponsor/Superior (Strike out which is not applicable)

Contact Number: 1
For Hostel (Tick )
Contact Number: 2

8. Educational Qualifications
Examination Passed
% of Regular Private
Name Subjects Year Name of University / Board
Marks (Tick ) (Tick )
Class X

Class XII

Degree

Others

9. Details regarding the Institution last attended

Name of the Institution last attended Place Period of Study

Year ____________ to Year ___________

10. Qualifying Test (CAT/MAT/CMAT etc.) Yes No (If NO, candidate must appear for DBUPGET)

11. Qualifying Test Details (if applicable): Test Type: …………………… Score: …………………… Date of Test: ……………………
12. Please list academic distinctions, honours and awards.
Academic distinctions, honours and awards

13. Recommendations / References

Recommendations / References

14. Address for Correspondence (Do not give Post Box No. Leave a blank box between each unit of address like House No. Street Name, P.O., etc.)

City District

State Pin Code

15. Bank Details

(Application fee is RS. 1000.00 if you have a qualifying test score and RS. 1100 without it)

Demand Draft / Transaction No

Bank Name

Branch

16. E-mail address/ID

DECLARATION BY THE APPLICANT

I hereby declare that I have read and understood the conditions of eligibility for Master’s in Business Administration (MBA) programme for
which I seek admission. I fulfil the minimum eligibility criteria and I have provided necessary information in this regard. In the event of any
information being found incorrect or misleading, my candidature shall be liable to cancellation by the Institute at any time and shall not be
entitled to refund of any fee paid by me to the Institute. Further, I have carefully studied the rules of the Institute as provided in the
Prospectus and I accept them and shall not raise any dispute in future over the same rules.

Date: ………………………………………. (Signature of the Applicant)

Director’s / Panel Decision: Admission Granted

Admission Not Granted

Date:……………………. Signature of Director

IMPORTANT INSTRUCTIONS FOR CANDIDATES

1. Please send your Application form by Regd. Post / Speed Post to: Administrative Officer, Don Bosco Institute of Management
(DBIM), Joypur, Kharghuli, Guwahati – 781004, Assam.
2. Please retain the photocopy of the filled-in form for future reference.
3. Affix the photo and enclose the following: Details for IMPS/NEFT/RTGS
a) Certificates and Marksheets in support of your educational qualifications. Account: DON BOSCO INSTITUTE OF
b) Additional certificates and honours in support of work experiences, achievements and the like. MANAGEMENT, KHARGHULI
c) ST/SC/BC/OBC certificate, if applicable. Bank Name: SOUTH INDIAN BANK
d) Age Certificate / Class Ten Admit Card. Account No: 0473073000000222
e) Bank Draft of RS. 1000.00 / RS. 1100 (without qualifying test) towards Application form. IFSC Code: SIBL0000473