Form No.

Bharati Vidyapeeth’s
Institute of Management & Information Technology,
Sector – 8, C.B.D., Belapur, Navi Mumbai – 400 614.

Application for PGDBM Admission

To,
The Director,
Bharati Vidyapeeth’s,
Institute of Management & Information Technology,
Affix 1 passport size
Sector – 8, C.B.D., Belapur, photograph here
Navi Mumbai – 400 614. +
send 2 extra copies
of the photograph
A. CAT / ATMA / MAT / MH-CET / GMAT Score: ______________

Q.1) How did you come to know about BVIMIT? __________________________________________________

_________________________________________________________________________________________

Q.2) Why do you want to pursue your Management Studies at BVIMIT? _______________________________
_________________________________________________________________________________________

Q.3) How do you want to use your PGDBM qualification in future? ____________________________________
_________________________________________________________________________________________

B. NAME ______________________________________________________________________
(In block capital letters beginning with surname)

Date Month Year Years Months

C. 1 DATE OF BIRTH AGE

2 Male Unmarried RELIGION

_____________________________
Female Married PLACE OF BIRTH _______________________
NATIONALITY __________________________
3. DEGREE Appeared ______________________________________________________________________
Passed ______________________________________________________________________

4. MAIN SUBJECT(S) / BRANCH _____________________________________________________________

5. UNIVERSITY __________________________________ State of Origin _____________________________
6. ACADEMIC AWARD(S) if any ______________________________________________________________
7. EXTRA CURRICULAR ACTIVITIES __________________________________________________________
(Distinction / Award if any)

8. WORK EXPERIENCE, if any _______________________________________________________________

(Provide Certificates)

Name of Organisation _____________________________________________________________________

Position ________________________________________________________________________________
Date of Joining _________________________________ Years of Experience ________________________
D. ACADEMIC PERFORMANCE (Stages of Education)
Examination University / BoardMonth & year of passingClass / DivisionPercentage of Marks obtainedInstitution1.
S.S.C. / S.S.L.C2. HIGHER
SECONDARY /
PRE-UNIVERSITY3. INTERMEDIATE ./
PROFESSIONAL4. BACHELOR’S DEGREE
Enter marks only if final
result is declared5. MASTER’S DEGREE
Enter marks only if final
result is declared6. OTHER DEGREES /
DIPLOMA CERTIFICATES
Only if passed

E. 1. Father’s Guardian’s Name ___________________________________________________________

2. Occupation ___________________________________________________________
3. Address ___________________________________________________________
___________________________________________________________
Pin Code _____________________ Tel/Mob: ______________________
4. Annual Income (from all sources) ___________________________________________________________
E. Applicant’s Permanent Address: ___________________________________________________________
___________________________________________________________
Pin Code _____________________ Tel/Mob: ______________________
For Correspondence ___________________________________________________________
___________________________________________________________
Pin Code _____________________ Tel/Mob: ______________________

I have checked all the entries in this application and they are true. I have kept all enclosures ready to be
presented on demand.

Place: ______________________
Date: _______________________

* Please also attach a self – addressed envelope Signature of the applicant

FOR OFFICE USE ONLY (Candidate Evaluation)
1 BVIMIT Score ___________________________________________________________

2 Remarks on GD & PI ___________________________________________________________

___________________________________________________________