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Hi Info

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Submitted By mayank2896
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CANDIDATES ARE REQUESTED TO RETAIN THE PRINTOUT OF ACKNOWLEDGEMENT PAGE FOR FUTURE REFERENCE.

Personal Details
Name of Candidate:

Nationality:

Indian

Other Nationality:

Person with Disability/Differently
Abled (PWD/DA):

No

PWD/DA Category:
Do you require wheelchair support at the test centre?:

Disability Percentage:

Communication Address
Hno-19-1-914/3 Muralinagar Bahadurpura
Address :

State/Union Territory:

TELANGANA

Other State/Union Territory:

Country:

India

Other Country:

City:

Hyderabad

Pin Code:

Other Town/City :
Mobile Number:

500064

Other City With Other Country:
9290022422

Mobile Number (Alternate) :

Email Address:
Email Address (Alternate) :

Exam Centre City Preferences
Preferred City 1:

Hyderabad

Preferred City 2:

Vishakapatnam

Preferred City 3:

Vijayawada

Preferred City 4

Kurnool

Academics Details
SSC/10th Std/Equivalent Details
Aggregate marks:

March

Total Marks Obtained :

331

Maximum Marks :

600

SSC/10th Std/Equivalent Board
Name

Andhra Pradesh Board of Secondary Education

2011

Other Board Name:

HSC/12th/Equivalent/Diploma Course Details
Course Type:

HSC

Aggregate Marks:

58.99

Total Marks Obtained:

589

Maximum Marks:

1000

12th/Equivalent Board Name:

Andhra Pradesh Board of Intermediate Education

Other Board Name:
Duration of Diploma Course:
University/Board/Other Authority
Name:
Discipline:

Commerce

Other Discipline Name:

Month/Year of Course
Commencement:

Month/Year of Completion: March

2013

Bachelor Degree Details
Are you in the final year of Bachelor Degree?

Yes

Have you completed Bachelor
Degree?

Total Duration of Degree:

3 Year
74.00

Current Semester:

Semester-8

Aggregate Marks:

Type of University/Institution:

State University

Other Type of University/
Institution:

State/Union Territory Where
University is Situated:

Telangana

University Name:

Osmania

Other State/Union
Territory Where University is Situated:

Other University Name:
Name Of College:

Roots Degree College

Degree Name:

Others

Other Degree Name:

BBA

Discipline:

Management (Business Administration/Business Management/Business Studies/Management Studies)

Other Discipline Name:
Month/Year of Course
Commencement:

June

2013

Month/Year of Completion: March

2016

Other Professional Degree Details
Have you completed any professional degree such as CA/CS/ICWA without completing Bachelor's Degree:

No

Specify Other Professional
Degree:
Professional Inter Marks:

Professional Final Marks:

Month/Year of Course
Commencement:

Month/Year of Completion:

Master Degree Details
Do you want to enter Master
Degree Details?

No

Master Degree Completion Status:

Duration:

Current Semester:

Aggregate Marks:

Type of University/Institution:

Other Type of
University/Institution:

State/Union Territory of
University:

Other State/Union
Territory of University:

University Name:
Other University Name:
Name of College/Institution:
Degree Name:

Other Degree Name:

Discipline:
Other Discipline Name:
Month/Year of Course
Commencement:

Month/Year of Completion:

Work Experience Details
Automobiles/Auto-ancillaries

Banking/Financial Services

Durables

Engineering/Industrial

Fast Moving Consumer Goods
(FMCG)

Information Technology

Pharmaceuticals/Healthcare

Retail

Telecommunications
Others1 (Work Area)

Others1 (Exp In Month)

Others2 (Work Area)

Others2 (Exp In Month)

Others3 (Work Area)

Others3 (Exp In Month)

Total Work Experience (In Months)

0

Programme Details

IIM Ahmedabad PGP
(Interview City 1)

IIM Ahmedabad PGP
(Interview City 2)

IIM Ahmedabad PGP-FABM

IIM Ahmedabad FPM

IIM Amritsar PGP

IIM Bangalore PGP

IIM Bangalore PGP EM

IIM Bangalore PGP PM

IIM Bangalore FPM

IIM Bodh Gaya PGP

IIM Calcutta PGP PGDM

IIM Calcutta FPM

IIM Indore PGP

Programme IIM Indore PGP
Mumbai

IIM Indore EPGP

IIM Indore FPM

IIM Kashipur PGP

IIM Kashipur EPGPM

IIM Kashipur EFPM

IIM Kashipur FPM

IIM Kozhikode PGP

IIM Kozhikode FPM

IIM Lucknow PGP

IIM Lucknow PGP ABM

IIM Lucknow PGPSM

IIM Lucknow FPM

IIM Nagpur PGP

IIM Raipur PGP

IIM Raipur PGPWE

IIM Raipur EFPM

IIM Raipur FPM

IIM Ranchi PGDM

IIM Ranchi PGDHRM

IIM Ranchi FPM

IIM Rohtak PGP

IIM Rohtak EPGP

IIM Rohtak FPM

IIM Sambalpur PGP

RGIIM Shillong PGP

RGIIM Shillong PGPEX

RGIIM Shillong FPM

IIM Sirmaur PGP

IIM Tiruchirappalli PGP

IIM Tiruchirappalli PGPBM

IIM Tiruchirappalli PGPHRM

IIM Tiruchirappalli FPM

IIM Udaipur PGP

IIM Udaipur FPM

IIM Visakhapatnam PGP

Visakhapatnam

DECLARATION
I hereby certify that the particulars given by me in this Application Form are true to my knowledge and belief. I certify that I fulfill the CAT
2015 eligibility criteria and undertake to produce original documents whenever necessary and I will not demand any reschedule of exam. I understand all disputes will be subject to territorial jurisdiction of city of Ahmedabad only.

Images Uploaded by Candidate
Photograph

Signature

Candidate Photograph

Candidate Signature

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