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School of Business Public Policy & Social Entrepreneurship

MBA (Full-Time)
Photo

Data Sheet
Registration No. ________________

1. Name Mr./Ms.: ________________________________________________________


(As per Matriculation Certificate)
2. Date of Birth :
D
3. Gender:

Male

Female

4. Mailing Address: _________________________________________________________


_________________________________________________________Pin_______________

5. Permanent Address (if different from above) _____________________________________


___________________________________________________________Pin _______________
Mobile No.______________________E-mail_________________________________________

6. Category: General

SC

ST

OBC

CW

PD

(Enclose self attested photocopy of category certificate)


7. Education: (Starting Class X Board Examination onwards)
Examination

Year

Name of
School/College

Board/University

% of Marks
/Division

8.

Please specify the scheme under which you have graduated:


10+2+3 or Any other ________________________________________________

9.

Extra Curricular Activities ____________________________________________


__________________________________________________________________

10.

List of Academic Honors, Prizes, Scholarship or other awards obtained by you:


(attach separate sheet)
__________________________________________________________________
__________________________________________________________________

11.

Fathers Name ________________________________ Phone No.____________

12.

Mothers Name____________________________ Phone No.________________

13.

Work Experience (after graduation, if any including internship):


Organizations (s)

Designation(s)

From

To

Monthly
Salary

14.

Statement of Purpose: Discuss your career goals and state in about 200 words how
being at AUD, SBPPSE can help you to achieve these goals.

Signature of the candidate with Date

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