Name of the Applicant (IN BLOCK LETTERS)(as per P.U.C Marks Card)

1.

2.

3.

7.

No.

APPLICATION FOR ADMISSION TO MASTER OF BUSINESS ADMINISTRATION (MBA)

Name of the Parent

Father

Mother

A) Postal Address : (in Block Letters)

5. Occupation of Parent/Guardian

4. Father or Mother Pancard No

Annual Income

A) Nationality & Religion :

B) Caste : D) Caste Group : E) Sex :

C) State whether you belong to SC/ST or Cat I, II-A, II-B, III-A, III-B :

6. A) Date of Birth : D) Place of Birth :

B) Age : C) Blood Group : E) Mother Tongue :

C) Phone No. If any

1. 2.

Nearest Police Station :

Railway Station :

(of the Native Place)

B) Local Guardian Address/Phone No.

FOR OFFICE USE ONLY

GENERAL RULES

The applicant Mr. / Ms. .............................................................................................................................. has been

given provisional admission to 1st Semester M.B.A. for the academic year 200 - 200 .

Fees paid Rs. ....................................................................................... Vide Receipt No. ................................................

Dated ........................................................ Registration No. ................................................

USN :

Checked by Registrar Principal

1. Application is to be submitted to the Principal, S J B Institute of Technology, Kengeri,

Bangalore along with 6 Passport size and 6 Stamp size Colour Photos.

2. Application with incomplete information is liable to the rejected.

3. Original documents should be submitted at the time of admission along with three sets of

Xerox copies.

4. The candidates admitted will have to abide by the rules and regulations prescribed by the

authorities of the college and Vivesvaraya Technological University.

6. Those who want hostel facilities shall have to apply after admission to the college. Hostel

facilities are available for both boys and girls.

7. Eligibility Certificate in case of N.R.I. / Foreign candidate is to be submitted at the time of

admission.

To

The Principal,

S J B INSTITUTE OF TECHNOLOGY

Kengeri, Bangalore - 560 060.AFFIX

PASSPORTSIZE PHOTO

HERE

S J B Institute of TechnologyS J B Institute of TechnologyS J B Institute of Technology(Approved by AICTE-New Delhi, Affiliated to VTU, Belgaum)

BGS Health & Education City, Uttarahalli Road, Kengeri, Bangalore - 560 060.

Tel. : 080-28612445 / 6, 65901709, Fax : 080-28612651

E-mail : principal@sjbit.edu.in, Web : www.sjbit.edu.in

1. Institution strictly condemns any kind of direct or indirect involvement pertaining to ragging

and has anti ragging policy

2. Every student has to submit the affidavits pertaining to ragging in the prescribed format has

per the AICTE regulation on a stamp paper of Rs.10/-each, duly signed and sworn by

student and parents/guardian separately at the time of admission.

3. Those who want admission in hostel should submit a separate affidavit pertaining ragging in

the prescribed format signed and sworn by students on a stamp paper of Rs.10/- at the time

of admission.

ANTIRAGGING NOTICE

Sri Adichunchanagiri Shikshana Trust (R.)

II Jai Sri Gurudev II

8.

9.

EDUCATION DETAILS(Tick appropriate boxes wherever necessary)

Name of the Institution & Place last studied

Date of entering & leaving the Institution

Name of the Board / University

State

10.

11.Qualifying

Exam PassedName of the

University / BoardSem / Year

I

II

III

IV

V

VI

VII

VIII

TOTAL

Max.Marks

MarksObtained

Aggregate % of Total Marks

a) Qualifying Exam Passed

b) Reg. No. & Year

c) Optional Subjects

Original Documents along with three sets of attested copies of the following Certificates to be enclosed( Tick the ones enclosed)

a) Marks Cards of qualifying exams (Issued by the University/Board)

b) Marks Cards of PUC / 10+2

c) Passing Certificate of the qualifying examinations

d) 10th Marks Card

e) Migration Certificate

f) Transfer Certificate

Extracurricular activities (Achievements)

Admission Test Qualified / Not Qualified

Signature of the Applicant

Signature of the Parent /Guardian

Place :

Date :

Place :

Date :

I, .................................................................................. S/o / D/o ........................................................................

the candidate seeking admission to 1st Semester M.B.A, in S J B Institute of Technology, Kengeri, Bangalore

solemnly declare that I will strictly abide by the rules and regulations in force or those that may be framed hereafter

and will not indulge in any unsocial antinational activities. I will not involve in acts of indiscipline and breach of

rules. I will not involve in any form of ragging activity inside or outside the campus. I further agree to make good any

damage to furniture, apparatus etc., which may be due to carelessness on my part.

The information given above in the application is true and if found false, necessary action may be taken

against me.

I, ...............................................................................................................................................................Parent /

Guardian of the above applicant shall be responsible for the payment of fees, dues, loss or damage, if any.

I shall also be responsible for his / her conduct and good behaviour during the period of his/her studies in this

college.

I undertake to visit the Institution atleast twice in a year to know the progress of my ward.

DECLARATION

DECLARATION

13.

14.

15.

12. Admission Type : PG CET K-MAT MQ

1.

2.

3.

a) PG CET Order No. / Date

a) K-MAT Order No. / Date

a) Others

b) PG CET Rank

b) K-MAT Rank

b) Rank

c) PG CET No.

c) K-MAT No.

c) No.

d) Allotted Category

d) Allotted Category

deriuqeR stnemucoD

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