IIAM VIZAG | 1st Business School in AP | Estd 1987

0891-2552063, 2523676

ADMISSIONS OPEN 2018

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Instructions

Read the application form carefully before you fill it.

Please use ( √ ) tickt mark in appropriate boxes wherever required.

The application form will be attended only if all the required information is included. Please re-check form to ensure you have not left any data un-filled.

All Information you provide will only be used by our Admission Department and will remain strictly confidential.

(Affix Latest Passport size Colour Photograph)

PERSONAL DETAILS

Student Name in Full (in Capital Letters as in Class X records) :

Date of Birth :

Address :

City/Town :

State :

Country :

Pin code :

Gender :

Caste: (SC/ST/BC/OC) :

Mobile :

Landline (area code first) :

Mother Tongue :

E-mail:

IF DIFFERENT FROM THE ABOVE, PLEASE GIVE YOUR PERMANENT ADDRESS

Address :

Mobile :

Landline (area code first) :

FAMILY DETAILS

Mother's/Spouse's Full Name:

Occupation:

Name of Organisation:

Contact No. :

Father's Full Name :

Occupation :

Name of Organisation :

Contact No. :

ACADEMIC QUALIFICATION (FROM CLASS X ONWARDS)

  • Course
    Board University
    Medium of Instruction
    Year of Passing
    Class / Division
    % of Marks
  • Class X *

  • Intermediate/XII *

  • Graduation
    (Specify Degree) *

  • Others (Specify)

* Candidates who have appeared for the Final year degree have to mention the average marks upto the previous year (eg. fourth year Engg. students must submit marks upto 3rd year).

ACADEMIC QUALIFICATION (FROM CLASS X ONWARDS)

Name of the Graduation College

Graduation Degree

Contact No.

College Address

WORK EXPERIENCE

Organisation

Designation

Years of Service

Nature of Work

TEST INFORMATION

  • Test
    Date taken / To be taken
    Regn. No.
    Composite Score / Total Score
    Percentile
  • CAT

  • XAT

  • MAT

  • ATMA

  • Other All India. Tests (Specify)

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