AIMED Application Form

Download as pdf or txt
Download as pdf or txt
You are on page 1of 3

Application No.

Aachi Institute of Management and Entrepreneurial Development


th

No. 1050,III floor, I Block, 18 Main Road, Anna Nagar West, Chennai - 600040 www.aimed.in

In collaboration with

Bharathidasan University
Business Development Centre, Tiruchirappalli - 620 024

APPLICATION FORM
Postgraduate Diploma in Management and Entrepreneurship (PGDME)

Photo
with
Signature

1. Name of the Applicant

..

2. Mobile No.

..

3. e-mail id

..

4. Address

.
.Pin..

5. Date of Birth

6. Sex

7. Nationality

Male / Female

8. Religion

9. Community

OC / BC / MBC / SC / ST

(Put
mark in the appropriate
place proof to be attached)

10. Name, Address and Mobile No.


of Parent / Guardian

.
.
......................
.Mob.
Pin.

11. Details of Qualification / Marks (Proof to be attached)

No

Course
Institution

+2

Degree

Others

Board / University

Marks secured
Month & Year
/ Max. Marks Percentage
of Passing

12. Any other relevant information (use additional sheets if required):


List of Enclosures
1)
2)
3)
Declaration
I declare that the above statements are correct and complete to the best of my knowledge.
I solemnly assure you that I will obey the authorities of the Institution. I will not indulge in activities
detrimental to the interest of the institution. I am aware that in matters of discipline the decision of
the Institution authorities is final.
Station:
Signature of the Applicant
Date:

Fees Details
Please enclose an application fee of Rs. 500/- (Demand Draft drawn in favour of The Registrar,
Bharathidasan University, Payable at Trichirappalli). Filled in application (along with Demand
Draft) should be sent to The Director, Aachi Institute of Management and Entrepreneurial
Development, No. 1050, III floor, I Block, 18th Main Road, Anna Nagar West, Chennai- 600 040

For office use only


Date of receipt of application form:

Form No:.

Particulars of Application fee paid: DD. Amount Rs. . DD.No . Date. .......
Name and place of issuing bank .
Date of Scrutiny of filled in application form: .
Remarks: Eligibility for Admission: Yes / No

Signature of Director

You might also like