please send this application form along with

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Please send this Application Form along with 1)Demand Draft for Rs.1,200 to wards cost of IBSAT 2010 Application Material (demand draft should be drawn in favo r of "IUCF A /c IBS" payable at Hyderabad) 2) Attested copies of X Cla ss, XII Class and graduation markssheets (Year Wise / Semester Wise), stude nts who are pursuing th eir final year degree have to attach the marksshee ts till last semester/year to Admissions Officer, IBSAT Office, #6 -3-354/1/2, Hindi Nagar, Punjagutta, Hyderabad-500034 IBSAT 2010 ONLINE APPLICATION FORM ( DECEMBER 26, 2010) Application No. 752011 Name of the Applicant (Use capital letters) MOUMITA SAMANTA Application No. 752011 Test Center (Code) New Delhi (GeethaColony)  (531) Gender  Female Indian Citizen  Yes Medium of Instruction ( English ) Y/N Class X  Yes Class XII Yes Degree  Yes Date of Birth (DD/MM/YEAR) 20 01 91 Academic Record Class X  Agg. Marks (%) Year of Passing 70 2006 Class XII 86.7 2008 Qualification (Code) Mode of Study Duration of Course (No. of Yrs) Status   Agg. Marks (%) Year of Passing Bachelor's Degree BBA/BBM/BBS (23) Distance Learning 3 Years Final Year  59 2011 P.G Qualification - Professional Qualification - Work Experience as on May 31, 2011: Nil Address (full postal address) 9  /808 PREM GALI-2E GANDHI NAGAR DELHI City New Delhi State (Code) Delhi (06) Pin code 110031 Mobile 9873428338 Telephone Number 9873428338 Name (Write your name the way it is mentioned in your School/Degree certificates.) MOUMITA SAMANTA E-Mail Address 1 MOUMITA389@GMAIL.COM E-Mail Address 2 [email protected] 

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Page 1: Please Send This Application Form Along With

8/8/2019 Please Send This Application Form Along With

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Please send this Application Form along with1)Demand Draft for Rs.1,200 towards cost of IBSAT 2010 Application Material (demand draft should be drawn in favor of "IUCF A /c IBS" payable atHyderabad)2) Attested copies of X Class, XII Class and graduation markssheets (Year Wise / Semester Wise), students who are pursuing th eir final year degree haveto attach the markssheets till last semester/year to Admissions Officer, IBSAT Office, #6 -3-354/1/2, Hindi Nagar, Punjagutta, Hyderabad-500034

IBSAT 2010 ONLINE APPLICATION FORM ( DECEMBER 26, 2010)

Application No. 75 2011

Name of theApplicant (Use capital letters) MOUMITA SAMANTA

Application No. 752011

Test Center (Code) New Delhi(GeethaColony) ( 531 ) G ender Female

Indian Citizen Yes

Medium of Instruction ( English ) Y/N

Class X Yes Class XII Yes Degree Yes

Date of Birth(DD/MM/YEAR) 20 01 91

Academic Record

Class X Agg. Marks (%) Year of Passing 70 2006

Class XII 8 6.7 200 8

Qualification (Code) Mode of Study Duration of Course (No. of

Yrs) Status Agg. Marks (%) Year of

Passing

Bachelor'sDegree

BB A/ BB M/ BB S ( 23 )

DistanceLearning 3 Years F inal Year 59 2011

P .G Qualification -

P rofessionalQualification -

Work Experience ason May 31, 2011: Nil

Address(full postal address)

9 / 8 0 8 PREM GALI- 2 EGANDHI NAGARDELHI

City New Delhi S tate (Code) Delhi ( 06 )

P in code 110031 Mobile 9873428338 Telephone Number 9 8 7342 8 33 8

Name ( Write your name the way it ismentioned in your S chool/Degreecertificates.)

MOUMITA SAMANTA

E-Mail Address 1 MOUMITA 3 8 9@ GMAIL. COM

E-Mail Address 2 [email protected]

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Name & Address of the College (Degree)(Use capital letters)

JAGAN NATH INSTITUTE O F MANAGEMENT SCIENCES34, LAJPAT NAGAR- IVNEW DELHI110024

Name of theUniversity (Degree)(Use capital letters)

Guru Jambheshwar University , Hissar

Executive-Level work Exeperience (if applicable)

Employer's Name & Address Period of Service Designation Area of Work

From To -- -- -- -- --

Family income(per annum) : Above Rs.5 lakhs Declaration I declare that I have read and clearly understood the disclosure and the legal aspects and the eligibility criteria for admis sion into the IBSAT I herebyagree to abide by the same. I certify that I satisfy the eligibility requirements as stated in the IBSAT 2010 Application Material/Website.I hereby declare

that the information provided by me in theOnline Application is true and correct to the best of my knowledge. I have read, un derstood and agree to therules and regulations of IBSAT. P lace: New Delhi ______________________ Date: (MM/DD/YYYY) 11 / 3 / 2010 S ignature of the Applicant

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