ZEAL EDUCATION SOCIETY’S Form No.

:
ZEAL INSTITUTE OF MANAGEMENT AND COMPUTER APPLICATION
S.No. 39, Behind Bhairavnath Temple, Off. Narhe-Dhayari Road, Narhe, Pune – 411 041
Phone: - 020-67206041 / 67206042, Website: www.zimca.in, Email: zeal.zimca@gmail.com

Application for Admission to theFirst / Second/ Dual YearMBA (PG)Coursefor Academic Year ______
Paste here
Opted Specialization (For MBA II Year) - Fees Details: Neft/D. D. Latest
passport
ZPRN Roll No. Division Amount size Photo

D.D. No. D.D. Bank Name:

Sir/Madam,
I am submitting herewith the necessary details in the following format for admission to the of Course MBAatZeal
Institute of Management & Computer Application Narhe, Pune, for the academic year ________________.
Personal Information:
1. Student Name____________________________________________________________________________________
In Block letters - (Surname) (Name) (Father Name)
2. Gender (Male/Female)_________________________ 3. Date of Birth_________________________________
4. Rural / Urban_________________5. Blood Group _______________6. Mobile No. ____________________________
7. Present Address___________________________________________________________________________________
________________________________City________________Landmark_______________________
State ________________________________________Pin Code________________________________
8. Permanent Address________________________________________________________________________________
___________________________________________________________________________________
State________________________________________Pin Code________________________________
9. Email ID. (Gmail)______________________________________10. Religion_____________&Cast –___________
Subcast (If applicable)______________________
11. Domicile State of Student ___________________________ 12. Physically Handicapped (Y/N)__________________
13. Aadhaar Card No _________________________________ 14. Annual Family
Income___________________15.Pan Card No _____________________16. Passport No _________________________
17.NCC / NSS(Y/N) ________________18. Sports(Y/N) if yes name of sport____________________________________
19. Are you leaving in Hostel/ PVT. Room (Y/N)________if yes give address: __________________________________
__________________________________________________________________________________________________
20. Result Details :
Month Maximum Marks/ Total Marks Total Percentage /
Class Exam. Seat No.
& Year of Passing Grade (Out of) /Grade Obtained Grade Point earned
UG

PG (if any)

First Year MBA

Page: 1
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21. Information of the Parents/Guardian
Father Name ____________________________________________________________________________________
In Block letters - (Surname) (Name) (Father Name)
Mobile No. _________________________________ Occupation_________________________________________
Employment Sector___________________________ Designation________________________________________
Organization Name& Address: ______________________________________________________________________
Email ID______________________________________ Aadhar Card No. ____________________________
Mother Name ___________________________________________________________________________________
In Block letters - (Surname) (Name) (Father Name)
Mobile No. _________________________________ Occupation_________________________________________
Employment Sector___________________________ Designation________________________________________
Organization Name& Address: ______________________________________________________________________ .
Email ID_____________________________________ Alternative Cont. No. _______________________________
GuardianName__________________________________________________________________________________
In Block letters - (Surname) (Name) (Father/ Husband Name)
Mobile No. _________________________________ Occupation_________________________________________
Employment Sector___________________________ Designation________________________________________
Organization Name& Address: ______________________________________________________________________
Email ID____________________________________ Alternative Contact No. _____________________________

I hereby declare that:

1) I have not been debarred from appearing any examination held by any Government constituted or statutory examination authority of
India.
2) I have not been involved or no prosecution is pending against me in copying or any year case of misconduct at any college/University
examination.
3) I shall not ask for transfer from the aforesaid college to any other college/Institution under any circumstances.
4) The Particular furnished in the application form are correct to the best of my knowledge.
5) I will abide by the rules and regulations in force at present and that may be enacted and enforced in future by the institute, so long as I
am student of the institute.
6) I will do nothing either inside or outside the institute that will interfere with the ordinary governance and discipline.
7) I understand that my admission secured as a reserved category candidate given against the quota reserved for backward class category
is purely provisional and will be cancelled if the caste Certificate is cancelled/rejected/invalidated by the Directorate of Social Welfare
Maharashtra State and also subject to submission of Caste Validity Certificate and /Non Creamy Certificate (If applicable).
8) I am fully aware about the college fees being payable are subject to the revision of the fees by the Fees Regulating Authority [M.S.]
and I will pay the difference (if any) immediately on demand by the college authorities.
9) The conformation of the provisional admission depends upon my result of the university examination and in case I am not eligible, my
admission will get cancelled automatically.
10) In case I am not eligible for admission to higher class, I shall contact in person for completing future formalities or claiming refund as
per Institute’s rules & regulations.
11) I will remain regular in all respect and as far as possible try to attend all the theory lectures and practical throughout the year. I am also
aware about the college timings/ shift timings and if my overall attendance is less than 75% my academic term will not be granted.
12) I am giving consent for disclose/sharing of my personal information / data to the respective Government Authority/Office as per need.

Date: / / 20
Place: Pune
Student’sSignature

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 UNDERTAKING BY STUDENT AND PARENT’s

We undersigned M r . / M r s . __________________________________________________, father /Mother /Parent

/Guardian of_________________________________________, Class:- MBA,Year ____________Shift: 1st Shift/ 2nd
Shift, my ward -_________________________________________________________________
having been admitted to ZEAL EDUCATION SOCEITY’s Zeal Institute of Management & Computer
Application Narhe, Pune- 411041. I/We fully aware of the following regulations and norms of the Institute and
hereby undertake to strictly abide by the same.
1. I shall attend the college right from the first day of the Term as per the Time Table.
2.Minimum attendance required as per the Savitribai Phule Pune University is 75% for granting of the term. It goes without
saying that I should attend all the Theory and Practical classes sincerely and regularly without fail for achieving excellence in
Academics. I know that no special consideration is given even on Medical grounds.
3. I shall not get involved in any kind of RAGGING and antisocial activities. I am fully aware that ragging is an offence
punishable as per the law, resulting in imprisonment and / or heavy penalty. If I found involved in any such activity directly or
indirectly, I shall not only be expelled from the Institution, but the matter will be reported to the appropriate authorities, for
further action.
4. I am required compulsorily to submit minimum 6 Assignments and appear for 3 Tests in every subject with full preparation,
for granting of my Term.
5. I shall complete all the assignments after thorough preparation; I shall neither copy the same from others nor show others to
copy my assignments.
6. I shall read and follow all the instructions given by the Institute from time to time through its various Notice Boards, SMS,
E-mail, ZCOER Website, Announcement Systems, ERP or Oral Communications, etc.
7. I shall strictly maintain punctually while attending all the Theory and Practical Classes. In case required short / long leave I
shall take prior permission of GFM /Head of Department.
8.I shall put-on my college I-Card on every day without fail and will attend the college in full college uniform on the
specified days and on special occasions.
9. I shall dress my hair properly and put on a neat, decent formal dress of Trouser and Shirt / Salwar Kurta (for girls).
10. I shall not wear any objectionable / indecent dress / clothes like low waist jeans, 3/4th jeans or any shabby looking tight
dress during or after the working hours of Institute on the campus.
11. I shall participate in all curricular, co-curricular, extra-curricular, social, cultural and adventure activities at my own risk. In
case of any unfortunate event, accident, any type of injury or fatal casualty, Institution / Management / Faculty / Staff will not be
held responsible under any circumstances. I understand that any breach of the above rules, regulations and norms may
result in disciplinary action and even non-granting of my Academic Term. Once again I promise that I will attend the
college regularly from the First day of the Term.
12. I understand that, any admission secured as a reserved category candidate given against quota reserved for backward class
category is purely provisional and can be cancelled if the caste certificate is cancelled / rejected / invalidated by the any Govt.
Authority or admission authority and also subject to submission of Caste Validity Certificate and / Non Cream Layer
Certificate (if applicable).
13. I understand that, any admission secured as a reserved category candidate, I am liable to submit the Scholarship /Free-Ship or
any other concession form within the stipulated time period decided by concern Government Authority. In case I haven’t
submitted the same I will pay full applicable fees to institute within time, without any reason.
14. I am also made aware of the fact that the Management of Zeal Education Society’s Zeal Institute of Management &
Computer Application, Narhe, Pune - 411041, has submitted the proposal for increase in fees/ fixation of fees to Fees Regulating
Authority (M.S), Mumbai and the decision of the respected authority is yet to be declared. I hereby promise to pay the
additional amount of fees immediately, in case of upward revision in fee rates being declared by the Competent Authority.
15. I will also remain regular for the lectures, practical’s as per college/ shift timings. I will not directly or indirectly get involved
in any such at or behavior which will adversely affect my image and the image of the institute, failing which I shall be liable for
the disciplinary action which may result into cancellation of my admission.
16.I have read all the rules and regulations of the college regarding Discipline and Code of Conduct which are in force and made
applicable by the Management of Zeal Education Society, Pune and I promise to abide by the same.
I agree with the contents of Undertaking signed by my ward.

Student’s Full Name & Signature

Place: Pune, Date: / /20 Full Name & Signature of the Parent’s/Guardian’s

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 UNDERTAKING REGARDING ANTI-RAGGING

I, M r / M s . ____________________________________________________________________[Student’s , Son of
Name]

M r . / M r s . _______________________________________________________________________________[Parent’s
C l a s s : MBA, Y e a r : _____________________, Shift: 1st Shift/ 2nd Shift, haveb e e n a d m i t t e d to Zeal
Name]

EducationSociety’sZeal Institute of Management & Computer Application Narhe, Pune -41.

and
I, M r . / M r s . _________________________________________________[Parent’sName], father /Mother /Parent /Guardian
of Mr./Ms. _________________________________________________[Student’s Name] , Class:
MBA,Year: ___________________________________________________________ or SY-MBA, Shift: 1st Shift/ 2nd Shift,
my ward having been admitted toZeal Institute of Management & Computer Application Narhe, Pune – 411041.
We have received a copy of the UGC Regulationson Curbingthe Menace of Ragging in Higher Educational Institutions
2009, (hereinaftercalledthe“Regulations”) carefully readandfullyunderstoodtheprovisionscontainedinthe
saidRegulations.

Wehave,in particular,perusedclause3oftheRegulationsand a mawareastowhatconstitutesragging.

We have also, in particular, perused clause 7 and clause 9.1o the Regulations and aim fully aware of the penal and
administrative action that is liable to be taken against me / My ward incaseI / my ward found guilty of or a be tting
ragging, actively or passively, or being part of a conspiracy to promote ragging.

We hereby solemnly a ver and undertake that:

a. I / My ward willnotindulgeinanybehaviororactthatmaybeconstitutedasraggingunderclause3 of the
Regulations.
b. I /My ward willnotparticipateinorabetorpropagatethroughanyactof
commissioneromissionthatmaybeconstitutedasraggingunderclause3oftheRegulations.
2. We here by affirm that, if found guilty of ragging, I am liable for punishment is according to clause
9.1oftheRegulations,withoutprejudicetoanyothercriminalactionthatmaybetakenagainst me / my war d
underanypenallaworanylawforthetimebeinginforce.

3. We hereby declare that I have not been expelled or debarred from admission in any institution in the
country on account of being found guilty of, abetting or being part of a conspiracy to promote, ragging; and
further affirm that, in case the declaration is found to be untrue, I am aware that my / my ward’s admission
is liable to be cancelled. Declared this _____________________________ day, date: / /20 .

Signature of Father /Mother /Parent /Guardian Signature of student

** FOR OFFICE USE ONLY **

Signature with Date:

Signature with Date:
Form checked by: ____________________
Fees Checked by A/C: _____________________________
Name :- _____________________________ Name:- _____________________________________

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