Xaviers Institute of Business Management Studies, Bangalore

# 1678 A, 1st floor, JBA Complex, 60 Feet Nehru Road, Opp. London Bridge Showroom, Bangalore -
560084 , Phone - 8095195306, Website : www.xibms.com; Email : info@xibms.com

Course Details
Specialisation -

Students Name
Surname First Name Middle name
Father's /
Husband's
Name Surname First Name Middle name
Address & Email ID

Address and
Phone Details

Examination
Degree / Certificate Institution Month Year Subjects or Specialisatio
Academic
details ( In
Chronological
order including
exmas for
which results
are pending)

i iv
Work
Experience
starting with ii v
Latest one
iii vi
Exam Option ( Home / Study center) Additional Comments if any

Declaration - I certify that all information provided in this application is complete and
Other details accurate. I agree to familiarize myself with all the rules and regulations of the program
set forth by XIBMS and abide by them.
 Requirements - (a)Photocpies of Attested Mark Sheets (b) - Two latest passport size color photo ( c ) - Wo
Applicants are required to fill the application form and pay the fees at the time of admission
Students can pay the Fees Either in Cash or by Cheque / D.D.
Cheque / DD should be drawn in favour of " Xaviers Institute of Business Management Studies" Payable a
Admission Application form along with the Fees should be couriered / Posted to the XIBMS office by Speed post
Procedure
Fees once paid will not be refunded in any circumstances.
Course once selected can not be changed. You can change the course only on day of admission till the wo

www.xibms.com
s, Bangalore
Please Affix Latest color Photograph
here
howroom, Bangalore -
o@xibms.com

Gender -

Nationality -
Middle name Date of Birth

Middle name In dd/mm/yy format

Residence Phone

Office Phone

Mobile Number

Results / Grades /
Subjects or Specialisation Percentage

Fees Paid (INR)

Date
Place
Signature
ort size color photo ( c ) - Work Exp certificate
me of admission

agement Studies" Payable at Bangalore

MS office by Speed post

n day of admission till the working hours.

s.com