Online Admission Form First Name Last Name Permanent Address Father Name: Father's Mobile No.: Date of birth (dd-mm-yy) Course Applied PGDM Category SC ST OBC GENERAL Gender: Male Female Hostel Accommodation Required Yes No Qualification Name of Examination Board/University/Institute Year of passing % Marks obtained Main Subjects High School Select 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Intermediate(10+2) Select 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Graduation Select 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Examination Details CAT Roll No. Score Percentile MAT Roll No. Score Percentile UPSEE Roll No. Score Percentile OTHERS Roll No. Score Percentile Professional Qualification Experience & Company Name Period(in Years) Name of the Company Position Responsibilty HOW DID YOU FIND OUT ABOUT JAIPURIA SCHOOL OF BUSINESS PLEASE SPECIFY THE SOURCE. Alumni: Newspaper: Friend/Relative/Parent: Magazine: Website: Social Media: Coaching/Institute: Radio: Other(s), Pls. specify: Hobbies & Extra-curricular activities Declaration I hereby declare that the information given in the Application form is true to the best of my knowledge and belief. If any information is found to be wrong, i shall be liable for action. I hold myself responsble for the due and prompt payment of fees. Date Security code By clicking Submit, I authorise the Institute to get in touch with me via Phone or Email Online Admission Form First Name Last Name Date of birth (dd-mm-yy) Permanent Address Mobile Number Email Father Name Father's Mobile Number Course Applied PGDM Category SC ST OBC GENERAL Gender Male Female Hostel Accommodation Required Yes No Qualification High School Select 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Intermediate(10+2) Select 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Graduation Select 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Qualification CAT MAT UPSEE OTHERS Professional Qualification Experience & Company Name How did You Find Out About Jaipuria School of Business Please Specify the Source. Hobbies & Extra-curricular activities Declaration I hereby declare that the information given in the Application form is true to the best of my knowledge and belief. If any information is found to be wrong, i shall be liable for action. I hold myself responsble for the due and prompt payment of fees. Date Security code By clicking Submit, I authorise the Institute to get in touch with me via Phone or Email
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