FMS Executive Mba Application

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This document was authored by FMS Delhi. The application form is for admission toward 2012 MBA executive program of FMS Delhi

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Content

Form No.

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FACULTY OF MANAGEMENT STUDIES
UNIVERSITY OF DELHI, DELHI - 110007

APPLICATION FORM FOR ADMISSION TO THE MBA-EXECUTIVE & MBA-EXECUTIVE(HCA) TWO YEAR EVENING PRQGRAMMES(2012-2014)

Tick V ' appropriate boxes above and attach the correct Bank Draft. Application would not be processed further if the correct Bank Draft is not found attached to the form.
a. b. c. d. e. Application form duly filled in, must reach the Assistant Consultant, Faculty of Management Studies, University of Delhi, Delhi - 110007 latest by 12 June, 2012, at 7:00 P.M. All Application forms of SC/ST/OBC/PH/CW candidates, if not attached with self attested photocopy of relevant category certificate, will be rejected. OBC Non-creamy Layer certificate must be Please affix a copy enclosed with the form. Creamy Layer OBC candidate should apply under General Category. of recent colour Incomplete application forms will be rejected. No refund will be made for rejected applications. photograph and sign All original certificates will be required at the time of interview. The decision of the Faculty of Management Studies regarding admission will be final and binding on the applicant. Use BLOCK Letters to fill up the form. Tick 1. 2. 4. Name (As per
Matriculation Certificate)

the appropriate box. First Y Y Y Y Middle 3. Gender: Male | Surname | Female

: Mr./Ms._

Date of Birth : Mailing Address: Pin

D

D

M M

Mobile/Phone No

E-mail.

5.

Permanent Address:

Pin
6.

Mobile/Phone No | | Married 7. Nationality: "| SC | | ST | | OBC*

Marital Status: | Category:

|

Single

8.

(Enclose self attested photocopy of category certificate) | ] CW-I Q 9. CW-II Q CW-III Q • Yes CW-IV Q No

| General CW-V

*NOTE : OBC Must only be from central list and from Non-creamy layer

Have you applied to FMS before ? : (If yes, year in which applied) :



PH

Visual



Hearing



Locomotor



Form No.
10. Father's Name : Official Address : Pin 11. Mother's Name : Official Address :
(if any)

Occupation Mobile/Tel.No.: Occupation

Pin

Mobile/Tel.No.:

12. Education starting with 12th onwards - Please see Selection Procedure for details Examination Subject Year Name of School/ College Board/ University % of Marks Obtained

13. Extra Curricular Activities

14. List of Academic Honors, Prizes, Scholarships or other awards obtained

Work Experience (after qualifying c raduation): Organization(s) Designation(s) From To Monthly Salary

UNDERTAKING
1. 2. 3. I declare that all the particulars given in the application form are correct and nothing has been concealed. If any information supplied is found incorrect, my candidature will stand rejected without any notice. I agree to abide by the rules and regulations of the Faculty of Management Studies, University of Delhi, Delhi. I also declare that on admission, I shall submit myself to the disciplinary jurisdiction of the Vice-Chancellor and other authorities of the University of Delhi, who are vested with the authority to take disciplinary action under the Act, the Statutes, and the Ordinances of the University

Date:

Signature of the Applicant

Form No.

CERTIFICATE

FROM

SPONSORING

AUTHORITY

Form without this certificate would be summarily rejected To be filled by the Sponsoring Authority. Any overwriting should be signed. The Sponsoring Authority should be your present employer or Head of your Organisation. Sponsoring Authority will not have any financial obligation on behalf of the candidate. Official Designation of the applicant in the Organization : Date of promotion to the present designation : How many employees (excluding peons & other class IV staff) work under the applicant? Applicant's level in the Organization (from top): Does his/her work involve tours outside Delhi? |Yes| Name of the Sponsoring Authority : Name of the Organization Address : Telephone No. : Registration No. of the Organization : I certify that I have gone through the application of Mr./Ms and he/she is an executive/administrator of this organization for years months and to the best of my knowledge, the particulars mentioned herein are correct. The company/organisation does not have any objection to him/her attending the MBA-Executive/MBA-Executive (HCA) Course, and appearing in its various Examinations. If more than one candidate applies from your company/organisation for the course, the screening may be done at your level and then recommended in order rank. No If yes, how often ?.

Name (in Block Letters) Signature Designation Official Seal Date

Form No.

4

Statement of Purpose
(to be written by the candidate at the time of interview) Discuss your career goals and state in about 250-300 words how being at FMS can help you achieve these goals.

(Signature of the Candidate)

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