INSTRUCTIONS FOR FILLING THE APPLICATION FORM
  • Application fee of Rs.750/- should be credited to SB A/c No.01152200033509 in the name of "NET-JKSH Institute of Management" at Syndicate Bank,Nitte. IFSC code : SYNB0000115.
  • Please enter the UTR number (Transaction number) for proof of remittance in the application.
  • You should ensure that you have filled in all required information
  • For more information visit our website www.jkshim.nitte.edu.in or send a mail to info@nitte.edu.in

ADMISSION FORM
MBA PROGRAM

PERSONAL DATA

*Name: Mr./Ms.
Please upload your photograph
Gender Male   Female
*Date of Birth (dd/mm/yyyy)
Nationality Marital Status Single    Married
Caste (Specify)
Indicate Category as per State/Central Government Notification
Religion
Mother Tongue Annual Family Income
State of Permanent residence Blood group
Father's/Guardian's Name Occupation
Mother's Name Occupation
Mailing Address: click here
to copy the address
Permanent Address:
Pin code: Pin code:
Tel No.(with code): Tel No.(with code):
*Mobile: Mobile:
*E-Mail:
Place of residence - Urban / Rural:

ACADEMIC QUALIFICATION

Provide complete information on examination marks obtained in all columns. Marks stated in these columns must tally with those in the original mark sheets.

Examination Passed SSLC HSC/PUC Degree*
Name of the School/College
Name of the Board/University
Register No.
Marks Obtained / Total Marks      
Aggregate %
Year of passing


*Those awaiting final year results shall furnish details of earlier exams
*If you are appearing for the final year / semester Bachelor's Degree Exam, indicate month & year of examination

Month & Year

*Please note that, if you are selected, you will be allowed to join the program only if you submit a certificate at the time of interview from the Principal / Registrar of your College / Institute or University that you have completed all requirement for obtaining the Bachelor's Degree.


EMPLOYMENT DETAILS

Name of the Employer Designation Tenure
From:   To:
From:   To:
From:   To:

DETAILS OF ENTRANCE TEST

Test Date of Test Test Centre Score

NEFT REFERENCE ID or TRANSACTION NUMBER or CHALLAN NUMBER

*

AADHAR NO


PAN CARD NO.( Father )PAN CARD NO.( Mother )



DECLARATION BY THE STUDENT

I have carefully read the details regarding admission to the MBA course. I declare that the information provided by me in this application is true and correct to the best of my knowledge. Should it be found that the information furnished is untrue in material particulars, I know that I am liable for criminal prosecution and will forego the allotted seat. In all matters regarding my admission to the course, the decision of the College is final and binding. I am also aware that the college will not refund the fees either in full or in part, under any circumstance. If I intend to discontinue the course at any time after joining, I hereby undertake to pay the college fees and dues as applicable for the remaining years of the course. I agree to abide by the rules and regulations of the College that may be framed from time to time. I am aware that any dispute arising out of the admission to the course will be subject to the jurisdiction of the courts of the city of Mangalore or the Honorable High Court of Karnataka.


Place Agree to the condition
Date29-04-2017

DECLARATION BY PARENT OR GUARDIAN
(Declaration to be signed by the guardian, only if both parents of the applicant are not alive)

I,* hereby affirm that the information provided and enclosures submitted thereto in this application of my son/ daughter/ward * for admission to MBA course is true and correct to the best of my knowledge. Should it be found that the information furnished is untrue in material particulars, I know that I am liable for criminal prosecution and he/she will forego the allotted seat. I am aware that in all matters regarding his/her admission to the course, the decision of the College is final and binding. If my ward decides to discontinue the course, at any time after joining, I hereby undertake to pay the college fees and dues for the balance duration of the course. I am also aware that the College will not refund the fee either in full or in part, under any circumstance. I am aware that any dispute arising out of the admission to the course will be subject to the jurisdiction of the courts of the city of Mangalore or the Honorable High Court of Karnataka.


Place Agree to the condition
Date29-04-2017

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