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Tata-Dhan Academy Registration No : th Application for 14 Programme in Development Management (PDM XIV) : 2013-2015 /Home Address (With Father’s Name) Guardian’s Name/Address in Tamil Nadu / Andra Pradesh / Karnataka T. Malaipatti, Thenkarai B.O., Mullipallam S.O., Sholavandan , Vadipatti (TK), Madurai District 625 207. Tel: 04543-293405; Fax: 2602247; Email : [email protected]; [email protected] (Via) Instructions ¥ Please read carefully before completing. ¥ Fill in the application in your own handwriting with a ball-point pen. ¥ Incomplete application will not be considered. ¥ Write the name and location of the nearest telegraph office without fail. ¥ Don’t leave any box or column blank. Write NA if ‘Not Applicable’. ¥ Last date for the receipt of filled-in application is December 15, 2012. Name: Name: Father’s name:

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Page 1: Application Form withour border - DHAN FoundationDAMT Score Part A Part B Group Discussion Rank Sec 1 Sec 2 Sec 3 Net Score : Part C Personal Interview Aggregate Score Selected Y N

Tata-Dhan Academy

Registration No :

thApplication for 14 Programme in Development Management (PDM XIV) : 2013-2015

/Home Address (With Father’s Name)

Guardian’s Name/Address in Tamil Nadu / Andra Pradesh / Karnataka

T. Malaipatti, Thenkarai B.O., Mullipallam S.O., Sholavandan , Vadipatti (TK), Madurai District 625 207.Tel: 04543-293405; Fax: 2602247; Email : [email protected]; [email protected]

(Via)

Instructions

¥ Please read carefully before completing.

¥ Fill in the application in your own handwriting with a ball-point pen.

¥ Incomplete application will not be considered.

¥ Write the name and location of the nearest telegraph office without fail.

¥ Don’t leave any box or column blank. Write NA if ‘Not Applicable’.

¥ Last date for the receipt of filled-in application is

December 15, 2012.

Name: Name:

Father’s name:

Page 2: Application Form withour border - DHAN FoundationDAMT Score Part A Part B Group Discussion Rank Sec 1 Sec 2 Sec 3 Net Score : Part C Personal Interview Aggregate Score Selected Y N

3. Education

4. Work Experience

Date and Year Employer’s Name &

Location From To

Job Title Nature of Job

1. Date of Birth 2. Details of Registration Fee Payment

Date Month Year

Age :st(as on 1 July 2013)

Marital Status :

Are you a first graduate from your family : Y N

Bank & Branch

DD No. Date:

Amount

Application and Registration Fee Rs. 300/-

5. Extra Curricular Activities

Secondary School (10th)

Higher Secondary School (10+2)

Bachelor’s Degree in

Master’s Degree in

Qualification Name of the College/ University and Location

Month & Year

From To

Marks/OGPAobtained

Percentage ofMarks

Page 3: Application Form withour border - DHAN FoundationDAMT Score Part A Part B Group Discussion Rank Sec 1 Sec 2 Sec 3 Net Score : Part C Personal Interview Aggregate Score Selected Y N

Languages Speak Read Write

6. Languages Known

The Hindu

Down to Earth

Economic & Political Weekly

Vernacular Newspaper

Friends

Seniors

Poster

College / Faculty

Website

Others

8. What other courses you applying to ?

9. What is your ambition in the next five years? (Not less than 300 words)

are

7. How did you come to know about this course?

(put a ü mark in appropriate box)

Page 4: Application Form withour border - DHAN FoundationDAMT Score Part A Part B Group Discussion Rank Sec 1 Sec 2 Sec 3 Net Score : Part C Personal Interview Aggregate Score Selected Y N

10. What do you know about Tata-Dhan Academy? How did you come to understand about the Academy? (Not less than 300 words)

11. Why do you want to pursue your career in the development sector? Narrate an incident which made you to decide to be in the sector. (Not less than 300 words)

Page 5: Application Form withour border - DHAN FoundationDAMT Score Part A Part B Group Discussion Rank Sec 1 Sec 2 Sec 3 Net Score : Part C Personal Interview Aggregate Score Selected Y N

12. Write about yourself and your family. (Not less than 300 words)

Tata-Dhan AcademyDevelopment Management Admission Test (DMAT), 2013

DMAT Date : Time : 10.00 a.m. - 1.00 p.m. Admission Coordinator

Name :

Centre Name &Address :

Registration Number :

Admit Card

13. Write your commitments in the family and expectations of your parents.

Page 6: Application Form withour border - DHAN FoundationDAMT Score Part A Part B Group Discussion Rank Sec 1 Sec 2 Sec 3 Net Score : Part C Personal Interview Aggregate Score Selected Y N

14. Check the following before sending the filled in application (put a ü mark)

Filled in admit card

Self-addressed envelope

Signature

Demand Draft

Self-attested photographs affixed in application

15. Declaration

I hereby confirm that to the best of my knowledge, the information I have provided in this application is complete and true

Date : Signature

(For office use only)

Registration Number

DAMT Score

Part A

Part B

Group Discussion

Rank

Sec 1 Sec 2 Sec 3 Net Score :

Part C

Personal Interview Aggregate Score

Selected Y N

Instructions for DMAT

¤ Report at the centre by 9:30 a.m.

¤ Admit card has to be produced for attending the test

¤ Bring HB pencils, eraser, and sharpener for the test, besides a ballpoint pen

¤ Use of calculator and mobile phone is not permitted