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Page # 1
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BHAVAN'S INSTITUTE OF MANAGEMENT
SCIENCE
(Approved by A.I.C.T.E & West Bengal
University of Technology)
Block : FA : SECTOR III : SALT LAKE CITY : KOLKATA
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APPLICATION FOR ADMISSION TO MBA COURSE
YEAR : 2007
Please fill in the form in BLOCK LETTERS
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NAME OF THE
CANDIDATE :
_____________________________________________________________________
S/o D/o W/o :
_______________________________________________________________________
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Present Address |
Permanent Home Address |
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P.O. PIN
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P.O. PIN
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DIST. : STATE
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DIST. : STATE
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Phone No. |
Phone No. |
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PERSONAL DATA
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| Date of birth |
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Day .........Month .........Year......... |
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Affix
Recent
Passport size
Photograph
(attested)
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(Enclose documents) |
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Whether SC / ST / OBC
(attached documents) |
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| Marital Status |
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Married / Single |
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Filled up application
form to be submitted at Institute counter. |
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