Application for PGDM/PGDM-HRM/PGDM-IB 2021 Application ID : 14607373560 Allotted

Dear ABHINAV JAIN (CAT Reg No: 20017430),

Date Of Birth Gender Nationality Identity Proof Type

29/09/1995 Male Indian Aadhar Card
Identity Number Mobile Number Email
699043198375 +91 9582570670 abhi.jain2995@gmail.com

CAT Scores 2020:

VARC Percentile: DILR Percentile: QA Percentile: Total Percentile:
97.07 92.05 99.56 99.34

Hobbies/Co-Curricular Activities/Achievements:

Date Signature

PI Schedule
Date : Time : Venue :
16.03.2021 9:30AM Online

You are required to send the self attested soft copies of the following documents by reply e.mail once you receive an e.mail with the
zoom link from the Admissions office, MDI Gurgaon a day prior to your PI. Printout of the Application Form can be taken by clicking
on Print/Print Preview Button available on your application:
1. Application Form : You are required to complete this application form by filling the following details. You are
also required to upload all the documents(clearly visible), as mentioned below, on the portal:
2. CAT-2019 Score Card
3. Xth Board Certificate - Date of Birth Proof
4. Xth Board Marksheet
5. XIIth Board Marksheet
. Graduation Marksheet
7. Work Experience Proof # Pay Slip/Bank Statement of Salary (last 3 months) AND Job Offer Letter(s)/ valid work
experience certificate from your employer. # If you have worked in more than one company provide the
complete documents to prove your work experience.

In case you fail to provide the above mentioned documents, you will not be considered for Admission. You
are being invited for the selection process presuming that you meet the minimum eligibility criteria for the
Programme(s), you have applied for.
Campus and Interview Preference

Campus you wish to apply for? Interview Location

Gurgaon Gurgaon

Programme you wish to apply Programme you wish to apply Programme you wish to apply I have minimum 4 years
for PGDM: for PGDM-HRM: for PGDM-IB: bachelor’s degree:
Yes Yes Yes Yes
I have minimum 1 year of work Work Experience (in Months) Family Income (Family
experience after the as on 31/12/2020: comprises of Individual,
completion of my 4 years 42 Spouse & parents):
bachelor’s degree: 1000000 - 1499999
Yes

Address for Communication

Permanent address Communication address

A-52, 1ST FLOOR, SURAJMAL VIHAR, DELHI, DELHI, India A-52, 1ST FLOOR, SURAJMAL VIHAR, DELHI, DELHI, India
- 110092 - 110092

Academic Qualification Details

Class 10 Or equivalent Details

Board Name of Institution Passing year Percentage

Central Board of Secondary BAL BHARATI PUBLIC 2011 95
Education, CBSE SCHOOL

  English Science Maths Social Studies Hindi

Maximum Marks 100 100 100 100 100
Obtained Marks 95 95 95 95 95

Class 12 Or equivalent Details

Board Name of Institution Passing year Percentage

Central Board of Secondary AHLCON PUBLIC SCHOOL 2013 93.2
Education, CBSE

COMPUTER
  English MATHS PHYSICS CHEMISTRY
SCIENCE
Maximum Marks 100 100 100 100 100
Obtained Marks 90 98 95 91 92

Graduation

Name of institution University name Academic discipline Name of the Course

DELHI TECHNOLOGICAL DELHI TECHNOLOGICAL Engineering ELECTRICAL AND
UNIVERSITY UNIVERSITY ELECTRONICS
Status
Complete
Year of Passing Percentage
2017 78.67

Test Details
Test Appeared Registration Number
CAT 2020 20017430
Work Experience Details
 Last Drawn CTC(Per
Company Name Last designation Job responsibilities
annum)
HINDUSTAN PETROLEUM
CORPORATION LIMITED ( 1400000
02/07/2017 to 20/09/2020 )
Total experience (in Months)
38

Terms and Declarations

1. Have you ever been suspended, dismissed or put on academic probation/warning in your school or college?
no
2. Have you been charged or convicted of any crime(s) against properties involving the threat of violence? ( Affirmative responses
to these questions do not automatically disqualify you from admission)
no
3. Have there been any disciplinary proceedings initiated against you at your work place at any point of time ( whether the result has
been delivered or pending)
no

I certfiy that I satisfy the eligibility requirements for this programme and that all entries made in this application form, are true to the
best of my knowledge and belief. I am willing to produce original certificate(s) in support thereof if asked to do so at any stage during
the course. I agree to abide by decisions of Management Development Institute on all matters regarding this application.
No

Dated: 20-Sep-2020 09:08:00 AM

Disclaimer : This electronically generated information does not have legal validity. Student Signature