Date: ___________________ To, The Director, SCMHRD, Pune Subject: Request for cancellation of Admission I wish to cancel my admission

from the two-year full-time residential MBA program offered by your institute. I had applied for MBA program for the Batch of 2012-2014. I was selected and subsequently paid the fees, Rs.___________________ on ______________ (date) by bank draft no. _____________ dated _____________ (date) drawn on ________________________ (bank)
Following are my details:

SID Key: ___________________ Name: _________________________________________ Category: __________________ Selected through: Merit List / Waiting List 1 / Waiting List 2 Remarks with reason for withdrawal: ________________________________________________ ______________________________________________________________________________ Please mention the b-school you have been offered admission: ___________________________
(Please read your offer document carefully before filling the below details)

I also understand that as per the rules of the institutes Rs. __________ will be deducted and the remaining amount will be returned to me. I request you to kindly issue me the draft of the remaining amount of Rs. _________ in favour of ______________________ payable at ___________ (place). I also understand that hard-copy of this letter should reach SCMHRD by courier/speed-post on or before the date and time specified in the offer letter, otherwise this application would not be considered. Yours truly, ____________________________
(Candidates Name and Signature in acceptance)

______________________________
(Parents Name and Signature in acceptance)

(Note: Please do not send your application by email / soft copy format or fax as it would not be considered. Please attach a copy of your admission confirmation letter and receipt of payment along with this application) Received By Remarks (Asst. Registrar) Remarks (Accounts Dept)

(name, signature and date)