Institute of Business Management and Research

Application Form

Personal Details

Name: (in block letters) *

Present Address: (in block letters) *

Candidate Mobile No. * (To be used for Login)

Guardian Contact No.

Permanent Address: (in block letters) * (Check to copy Present Address)

Date of Birth *

Nationality *

Gender *

Marital Status *

Father’s/Husband’s Name *

Mother’s Name *

Father’s/Guardian’s Occupation *

Annual Income(in Rs) *

APPLYING FOR *

Academic Qualification

Academic Level	Name of the Board/University	Year of Passing	Class/Div.	Aggregate % of marks

Did you appear in any entrance exam?

Whether The Candidate Belongs To *

Serious ailments (if any)

OTHER DATA (IF ANY)(additional information regarding extra curricular activities)

Upload passport photo (JPEG/ PNG Format, Max 100KB) *

Upload signature (JPEG/ PNG Format, Max 100KB) *

Identity Proof: Aadhar/Voter ID (Max 100KB)*

Upload Marksheet/Certificate (JPEG/ PNG Format, Max 100 KB)*

Application Date

Place*

I hereby declare that the particulars furnished above are true to the best of my knowledge and belief. If at any time, it is proved that the said particulars are found to be untrue, I agree to my registration being cancelled without any obligation on the part of the Institute to refund fees paid by me. I also hereby agree to abide by all the rules and regulations framed by the Institute and the affiliating University from time to time.

APPLICATION FORM FOR PROVISIONAL ADMISSION

Application Form