Two-year full time residential MBA Programme, School of Management - KIIT University

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Personal 1
Personal 2
Personal 3
Education 1
Education 2
Work
Exam
Others
Declaration
Documents

Personal 1

First preference for GD & PI centre *

Second preference for GD & PI centre *

Third preference for GD & PI centre *

Fourth preference for GD & PI centre *

Fifth preference for GD & PI centre *

Personal 2

Your Name *

Email *

Date of Birth *

Mobile Number *

Religion *

Gender *

Marital Status *

Category *

Nationality *

Blood Group *

Mother Tongue *

Do you want to avail a study loan for the course? *

Are you physically challenged? *

If physically challenged, kindly provide details

Personal 3

Address for Correspondence *

City *

PIN Code

Country *

Father's Name *

Father's Occupation

Mother's Name *

Mother's Occupation

Emergency Contact Name(Mr./Ms./Mrs)

Emergency Contact Number

Relationship With You ?

Family Annual Income (Gross)

Education 1

Class 10th Board Name *

Class 10th School Name *

Class 10th Year of Passing *

Class 10th Division *

Class 10th Marks (in %) *

Class 12th Course Name *e.g., Sci, Arts, etc.

Class 12th Board/University Name *

Class 12th Institute Name *

Class 12th Year of Passing *

Class 12th Division *

Class 12th Marks (in %) *

Graduation Course Name *e.g., BTech, Bcom, etc.

Graduation University Name *

Graduation College Name *

Graduation Year of Passing *Expected year, if not already graduate

Graduation Division

Graduation Marks (in %)

Education 2

Post Graduation Course Namee.g., MA, Msc, etc.

Post Graduation Board/University Name

Post Graduation College Name

Post Graduation Year of Passing

Post Graduation Division

Post Graduation Marks (in %)

Other Course Name

Other Board/University Name

Other College Name

Other Year of Passing

Other Division

Other Marks (in %)

Work

Name of current organization worked at

Period from which onwards you worked at current organization

Period till which you work at current organization

Designation at current organization

Responsibilities undertaken at current organization

Name of previous organization worked at

Period from which onwards you worked at previous organization

Period till which you worked at previous organization

Designation at previous organization

Responsibilities undertaken at previous organization

Name of other organization worked at

Period from which onwards you worked at other organization

Period till which you worked at other organization

Designation at other organization

Responsibilities undertaken at other organization

Exam

Entrance Exam 1 appeared

ID/ Regn No/ Roll No of entrance exam 1

Composite score/ Percentile secured in entrance exam 1

Entrance Exam 2 appeared

ID/ Regn No/ Roll No of entrance exam 2

Composite score/ Percentile secured in entrance exam 2

Entrance Exam 3 appeared

ID/ Regn No/ Roll No of entrance exam 3

Composite score/ Percentile secured in entrance exam 3

Others

How do you expect MBA to benefit you? *

Give an example of something that you did well. Why do you think you succeeded? *

Give an example of something you have failed in. Why did you fail? *

Declaration

I certify that the information furnished in this application is true to the best of my knowledge and belief. My application may be rejected and admission cancelled if any information provided herein is found to be incorrect at any time during or after the admission. * Yes