PGDM (ABM): 2019-21 Admissions

Application Form

CANDIDATE'S PERSONAL DETAILS

Registration Number (As applicable) CAT-2018
CMAT-2019
* Name of the Candidate
* Date of Birth
* Father’s Name
* Mother’s Name
* Category
* Gender Male
Female
* Whether Physically Disabled
Annual Income (For claiming reservation for OBC non-creamy layer attach valid certificate)
* Upload Photo

POSTAL ADDRESS FOR CORRESPONDENCE

* Address Line1:
Address Line2:
* State:
* City:
* Pin Code:
* Candidate's Mobile No.
* Email Address
Alternate Mobile No.

Educational Qualifications

Examination Subject Year of Pass Aggregate Percentage of Marks Name of the Board/University
* SSC/ Equivalent
* Intermediate/ Equ.
* Graduation
Post Graduation

Work Experience

From (Date) To (Date) Organization Name of Post

Application Fee Details

* Application Fee (Rs.) * Demand Draft No.
* Demand Draft Date: * Name of the Bank:

LIST OF ENCLOSURES
Proof of age (SSC Certificate), Graduate/Post Graduate (Provisional degree certificate. Marks Sheet), Proof of Employment, Category Certificate: SC/ST/PH/KM/ OBC certificate Non- Creamy Layer, Demand Draft.

Note: Attested copy of CAT-2018/CMAT-2019 Score Card must be received at CCS NIAM, Jaipur latest by 28th February 2019.

DECLARATION BY CANDIDATE:
I hereby certify that all the information furnished above is correct to the best of my knowledge and belief. I understand and accept that furnishing of any false information on my part will automatically lead to disqualification of my candidature and forfeiture of all payments made by me to CCS NIAM. I agree to abide by the code of conduct and rules as may be framed from time to time by CCS NIAM authorities for smooth conduct of the programme.

* Place * Date
Signature