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S.P. Mandali’s Prin. L. N.

Welingkar Institute of Management Development & Research

ADMISSIONS TO THE
PGDM PROGRAMS 2011-2013 AT MUMBAI AND BENGALURU CAMPUS
RECOGNISED BY AICTE, GOVT OF INDIA, NEW DELHI

Form No: XXXX

PART A
Personal Details

1. Full Name: Affix recent


XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXPassport Size
2. Date of Birth: colour photograph
Phone-022241415733
3. Program(s) applied for (in order of preference):

Preference 1:
Preference 2:
Preference 3:
Preference 4:
Preference 5: Signature
Preference 6:
Preference 7:

4. Educational Qualification:

Class 10:
Passing Month and Year:
School:
Board/ University:
Percentage: Class: GPA: Grade:

Class 12:
Passing Month and Year:
College:
Board/ University:
Percentage: Class: GPA: Grade:

Graduate Degree:
Passing Month and Year:
College:
Board/ University:
Percentage: Class: GPA: Grade:

Post Graduate Degree:


Passing Month and Year:
College:
Board/ University:
Percentage: Class: GPA: Grade:

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S.P. Mandali’s Prin. L. N. Welingkar Institute of Management Development & Research

5. Additional PG / Diploma:

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XXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

6. Computer Proficiency:

MS Word Internet Usage Adobe creative suite


MS Excel Email Usage CorelDRAW
MS Power Point None Google sketchup
MS Access
XXXXXXXXXXX

7. If you are active on social networking media, mention your ids on


a. LinkedIn:
b. Facebook:
c. Twitter:

8. Work-Experience after graduation: 100 Total Months:50

Organisation: m
rganization01
Designation:
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
From: Sept 2002 AN 30 2005 To: Nov 2006 JAN 30 2005 Months: 5010

Description of work: Handling the Reliance EPABX System. Maintaining the entire
the Plant
0
Organisation:
rganization01
Designation:
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
From: Sept 2002 AN 30 2005 To: Nov 2006 JAN 30 2005 Months: 5010

Description of work: Handling the Reliance EPABX System. Maintaining the entire
the lant
0
Organisation: R
rganization01
Designation:
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
From: Sept 2002 AN 30 2005 To: Nov 2006 JAN 30 2005 Months: 5010

Description of work: Handling the Reliance EPABX System. Maintaining the entire
the
Plant

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S.P. Mandali’s Prin. L. N. Welingkar Institute of Management Development & Research

9. Work-Experience during graduation:

Organisation:
rganization01
Designation: Nature of work:
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
From: Sept 2002 AN 30 2005 To: Nov 2006 JAN 30 2005 Months: 5010

Description of work: Handling the Reliance EPABX System. Maintaining the entire
the Plant
0
Organisation: R
rganization01
Designation: Nature of work:
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
From: Sept 2002 AN 30 2005 To: Nov 2006 JAN 30 2005 Months: 5010

Description of work: Handling the Reliance EPABX System. Maintaining the entire
th0

10.Family Background:

Father:
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Occupation: Highest Qualification:
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Organization: Steel Authority of India X
XXXXXXXXXXXXXXXXXXXXXX
Designation: Manager
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Mother:
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Occupation: Highest Qualification:
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Organization: N/A
XXXXXXXXXXXXXXXXXXXXX
Designation: N/A
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Sister/Brother:
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Occupation: S Highest Qualification:
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Organization: NMIMS NMIMSX
XXXXXXXXXXXXXXXXXXXXX
Designation: Student
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Sister/Brother: N/A XX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Occupation: Highest Qualification:
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Organization: N/A
XXXXXXXXXXXXXXXXXXXXXXX
Designation: N/A X
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

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S.P. Mandali’s Prin. L. N. Welingkar Institute of Management Development & Research

PART B
Kindly handwrite your response. Do attach any extra sheets if required
(Compulsory for all applicants)

11.State 3 of your strengths and weaknesses.

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12.What would you say are your hobbies or interests?

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13.Mention the states traveled within India and countries traveled to outside
India, if any

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14.Mention your achievements, both academic/non-academic in the last 5 years.

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S.P. Mandali’s Prin. L. N. Welingkar Institute of Management Development & Research

15.Mention names of any 2 books you have read in the last 1 year.

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16.In not more than 75 words describe why you want to pursue Management
Education.

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17.If there is anything you think we should know while we evaluate you,
use the space below. However if we have captured everything through
the form above, you may skip this question.

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S.P. Mandali’s Prin. L. N. Welingkar Institute of Management Development & Research

PART C1
(To be filled only by candidates applying to the PGDM E-BUSINESS program)

18.What interests you about the PGDM e-Business program at Welingkar?

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19.What according to you is the role of e-Business in today’s business


scenario?

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20. Which of your qualities or personality traits will help shape a career in e-
Business?

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21.What type of work/career do you aspire for – highlight sectors/verticals


and job roles of your interest?

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S.P. Mandali’s Prin. L. N. Welingkar Institute of Management Development & Research

PART C2
(To be filled only by candidates applying to the PGDM BUSINESS DESIGN program)

22.What interests you about the PGDM Business Design program at Welingkar?

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23.How do you think design thinking is related to Businesses?

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24.Describe in brief any creative work that you have done, cite as many
examples as possible

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25.What type of work/career do you aspire for – highlight sectors/verticals


and job roles of your interest?

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S.P. Mandali’s Prin. L. N. Welingkar Institute of Management Development & Research

PART C3
(To be filled only by candidates applying to the PGDM RETAIL MANAGEMENT)

26.According to you, which of your personality traits will help you in shaping a
successful career in the retail industry?

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27.Name any retail personality that you admire; either International or Indian,
and why?

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28.If you were given the opportunity to open your own retail store, what kind
of store will that be?

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29.In case you have worked in the retail industry before, what is the part of
your job that you liked the most and why? What did you dislike the most
and why?

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