ASSAM INSTITUTE OF MANAGEMENT

(A Government of Assam Society)

ADMISSION TO MASTER OF BUSINESS ADMINISTRATION (MBA) PROGRAMME: 2019-2021.

Affiliated to Assam Science and Technology University (ASTU)

APPLICATION FORM
• National Level Written test appeared (Please tick the one you have appeared)

CAT ATMA MAT CMAT XAT held on …….……………….………... (Attach photocopy of the scorecard)

FILL IN CAPITAL LETTERS ONLY (No block should be left blank)

01. Name (in capital letter): Affix a recent
(Coloured) Passport
size photograph
02. Date of Birth: 03. Place of Birth :

04. Phone Nos.: 05. Whether ST/SC/OBC/People with disability

/ BPL:

06. E-mail:

07. Name of the qualifying degree (e.g. BA / B.Sc. / B. Com. / B. E. / B. Tech. / MBBS or others.):…….……………………………

08. EDUCATIONAL QUALIFICATIONS (HSLC/SSC ONWARDS): Applicants whose Final results have not been declared
should give details of marks upto last examination. Attach self attested copies of marks-sheets from Matriculation
onwards.

Exam. or name Full Name of School/College Board/Council/University Year of Class / % of marks

of the passing Div.
equivalent
exam.
HSLC/SSC

Higher
Secondary
Degree
1st Year
Degree
2nd Year
Degree
3rd Year
Degree
4th Year or
others *
* In case of engineering and other courses as applicable

09. Distinction/Award/Special Achievements/Extra Curricular Activities/Work Experience (Candidates will have to

submit copies of documentary evidence in support):

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10. Father’s Name :

11. Father’s Occupation, Designation & Address:

12. Mother’s Name :

13. Guardian’s Name :

14. Relationship of Guardian to applicant:

15. Guardian's occupation, designation address:

(In case the guardian is one of the parents of the applicant, the name of the parent should be mentioned. In case guardian is other
than parent, full details of guardian should be given.)

16. Address of Correspondence: 17. Permanent address of applicant:

Pin: District: Pin: District:

18. Why do you want to pursue a career in management?

19. Do you want to avail Tuition Fee Waiver Scheme for low income group…........ Yes / No. (If yes please submit
documentary evidence of low family income such as BPL Certificate).

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Enclosed Demand Draft for Rs. 1000.00 (Rupees One Thousand) only drawn in favour of "Assam Institute of
Management" payable at Guwahati. D/D No………….……………………….……….. Dated ……………………………… Drawn
on…….……………………………………………………………………..
DECLARATION

I certify that the particulars given above are correct and true to the best of my knowledge. If at any time the above
information is found to be false, the Institute will have the liberty to take action as deemed appropriate. I agree to
abide by the Rules & Regulations of the Institute. I fully understand that the decision of the Institute about my
admission will be final.

Date: Signature:

Place: Name in Full:

INSTRUCTIONS:

While filling up the AIM Application Form, applicants are requested to note the following:

1. This application is a key part of the admission process. Fill each and every part of the Form carefully and
completely. In case any clause in the form is not applicable in your case, please write “Not Applicable” in the
space provided. Incomplete applications will be rejected. Admission granted on the basis of false information
will ipso facto be null and void.
2. In all matters relating to admission to the course, the decision of the institute Authorities will be final and
binding on the applicant. No correspondence will be entertained form the applicant regarding his/her non-
selection.
3. Please enclose attested copies of marks-sheet of all Board/University examinations you have appeared in.
4. Please provide a list of enclosures.
5. Applicants, whose graduation results are not available at the time of application, should clearly indicate their
marks for every year upto the pre-graduation level and enclose all marks-sheets.
6. The LAST DATE of submission should be strictly adhered to.

LAST DATE OF APPLICATION FORM SUBMISSION: 12 March 2019

Address to: Admission Coordinator
Assam Institute of Management
Bigyan Path, (Opposite IASST), Paschim Boragaon, Guwahati – 781035.
Phone: 0361-2131992; 098640-97462, E-mail: mail@aimguwahati.edu.in; website: www.aimguahati.edu.in

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