Admission Form

Course applied for: MBA in Aviation &

(Form shall be filled in capital letters as per matriculation certificate) Safety Management

1) Candidate’s Name: Sameer Bhikaji Pawar………………………………………………………………………………………………...

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2) Father’s Name: Bhikaji Pawar……………………………………………………………………………...

3) Mother’s Name: Sujata Pawar……...........................................................................................

4) Address: 25, Raghunandhan, Krushidevta Nagar Jalochi Baramati....................................................

Distt: Pune…………………… ………………………State: Maharashtra.......................................... Pin Code: 413102...........

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5) Mob No.: +91 9423013261……..….……...………………………….. WhatsApp No. +91 9423013261……………..

6) Select ID Type (voter ID, Passport, Aadhar, PAN card, Driving license) ID Number 9315 9133 3346…………

7) E-mail Id: samepawar@gmail.com………………………………………………………. D D M M Y Y Y Y

0 3 0 4 1 9 8 7
8) Date of Birth: 03-04-1987…………………………………………………………….
9) Gender: Male…………… 10) Nationality: Indian…………………………………………………11) Cat (Gen/OBC/SC/ST)
12) Are you employed: Yes……………….(yes/No), If yes, Name of organization: Falcon Aviation Services…………
13) Relevant Educational Qualification:
Examination Year of Board/University Marks All Subjects
Passing (%)
Secondary 2002 Maharashtra State 61.6 English, Marathi, Science, History Geography
Board
Sr. Secondary 2005 Maharashtra State 68 English, Mathematics Physics Chemenstry
Board Biology
Graduation 2020 Singhania 74 BSC Aircraft Maintenance Engineering
University

14) Detail of AME Course (Only applicable for AME student)

Stream Mechanical……………….. Name of AME institute: Hindustan Institute of Aeronautics, Bhopal……
Semester I II III IV V VI
Maximum Marks (Th+P) 1000 700 900 800 600 100
Marks Obtained 765 527 692 642 486 75
(Theory +Practical)
Month & Year of Passing Dec 2005 June 2006 Dec 2006 June 2007 Dec 2007 June 2008

Declaration by Applicant:
I solemnly declare and confirm that I am duly qualified to take admission in the course for which I have applied and all the certificates and
testimonials attached with my application are true and valid. I have fully satisfied myself about the legal status of the University i.e. it is an
autonomous statutory body with regulations making power for it’s functioning and the University is duly authorized and competent to take my
admission in the course for which I have applied and also to award the degree/ diploma as per rules and regulation of the University. I also undertake
not to ever raise any objection about Universities legal status to take my admission and award degrees on qualifying prescribed examinations. I also
undertake not to demand refund of fee/charges a paid by me. In case of any dispute/differences/claim of any value settlement by University
arbitration clause shall be applicable.
I shall always follow the rules and regulations of the University and in case of any breach thereto, I shall be liable to be penalized for the same which
may include expulsion from the University. I have read and understood the condition of eligibility for the course for which I have registered.

Sign of student Date: 14 March 2021……………..