NMAT ID:

FTMBA GD/PI 2010 APPLICATION FORM

GD/PI Interview Date

Session

Name

Date of Birth

Age

Sex

Address

City

Mobile Number

Telephone (Residence)

Telephone (Office)

Email

Community

Category
 Educational Qualification

Passing
SSC/Matriculation Board % of Marks
Year

HSC/Higher Passing % of
Board Stream
Secondary Year Marks

Under Graduate Name of UG Passing % of Marks % of Marks

University/ Institute
Degree Degree Year (completed) (appearing)

Post Graduate Name of PG Passing % of Marks % of Marks

University/ Institute
Degree Degree Year (completed) (appearing)

Last College Name

Work Experience Gross Salary Period

Company Name Designation
P.A From To

NMAT ROLL NO

Bank Details DD No Bank Name Demand Draft Date

I certify that all the information furnished by me is true and if at later stage any of my details are
found to be incorrect or if I am found to be ineligible or if I canvass for admission in any manner, my
application will be null and void and NMIMS decision will be binding on me.

Place :

Date :
Signature of the Applicant