Indira Gandhi National Open University - Bse Training Institute LTD

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INDIRA GANDHI NATIONAL OPEN UNIVERSITY - BSE TRAINING INSTITUTE LTD.

APPLICATION FORM FOR ADMISSION TO MASTERS IN BUSINESS ADMINISTRATION - FINANCIAL MARKETS


Instructions to fill the Application Form:
Write in English and CAPITAL LETTERS. Use only Blue / Black Ball point Pen. Use of Green / Red Pen and Pencil is prohibited.
Fill one character per box leaving a blank box between two words. Do not write outside the boxes. DO NOT USE PHOTOCOPY OF THIS FORM.
Forms should be sent to - The Admissions Incharge, BSE Training Institute Ltd.(BTIL), 18th Floor, P.J. Towers, Dalal Street, Mumbai - 400001
Enrollment No.: Affix enrolment number label (for office use only)

FORM NO.

Payment Details

PASTE AND SIGN ACROSS YOUR RECENT


PASSPORT SIZE COLORED PHOTOGRAPH
(with white background)

a) Online Transaction Details


Online Transaction Number
b) Demand Draft Details
D/D Number

D/D Date

D/D Amount
/

Bank Name

1 Applicant's Name (do not write Shri/Mr./Dr. etc.)


(First Name)

(Middle Name)

(Surname)

(Middle Name)

(Surname)

2 Father's/Husband's Name (do not write Shri/Mr./Dr. etc.)


(First Name)

3 (a) Address for Correspondence: House/ Flat No. Building, Street/Village/Mohalla (do no write Father's Or your name here)

City

District

State

Pin Code

3 (b) Telephone Number (with STD code)

3 (c) Mobile Number

0
3 (d) E-mail ID

5 Date of birth

4 Sex: Cross (X) the appropriate box


Male

Female

6 Nationality: Cross (X) appropriate box

Date

Indian

Month

Other

Year

Specify, if other: _______________________


7 Category: Cross (X) the appropriate box only

General

ST*

8 Marital Status: Cross (X) the appropriate box

SC*

Married

Divorced

Widowed

Unmarried

9 (a) Educational Qualifications (Please refer to 'Checklist' for attachments)


Year of graduation

Percentage of marks

(Final year students will mention 2012)

(Leave Blank if appearing)

Name of College

Name of University

9 (b) Stream: Cross (X) the appropriate box


Science
Graduate
Post Graduate
Specify, if others

Arts

Commerce

Engineering

Others

10 Work Experience
Duration in

Years

and

Months

Employed in (cross (X) the appropriate box)


Govt./Public Sector

Semi Govt.

Pvt. Sector

Self Employed

Annual Family Income (Cross (X) the appropriate box)


Upto Rs. 50000/-Rs.

50000 to 1 lac Rs.

1 lac to 1.5 lac

Rs. 1.5 lac to 2 lac

Above Rs. 2 lac

11 Exam Center Details


Given below are 2 lists of exam centers. Cross (X) the preferred exam center from List 1 and List 2
List 1 (you have to select one center)
Mumbai

Delhi

Kolkata

Chennai

Bengaluru

Hyderabad

Pune

Chandigarh

Cochin

Guwahati

Jaipur

Panaji

Patna

Rajkot

List 2 (you can select multiple centers)


Ahmedabad

Bhubaneshwar

Bhopal

Indore

Lucknow

Vadodra

Varanasi

Ludhiana

Nagpur

Noida

Kanpur
Ranchi

12 Attested photostat of submitted documents (Please list the documents attached with the form):
1

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

10

___________________________________________________________________________

___________________________________________________________________________

11

___________________________________________________________________________

___________________________________________________________________________

12

___________________________________________________________________________

___________________________________________________________________________

13

___________________________________________________________________________

___________________________________________________________________________

14

___________________________________________________________________________

DECLARATION BY APPLICANT
I hereby declare that I have read and understood the conditions of eligibitlity for the program for which I seek admission. I fulfill the
minimum eligibility criteria and have provided necessary information in this regard. In the event of any information being found incorrect or
misleading, my candidature shall be liable to cancellation by BTIL at anytime and I shall not be entitled to refund of any fee paid by me to BTIL.
I would like BTIL to update me on the new products and services.
I have carefully studied the rules of BTIL as printed in the prospectus and I accept them and shall not raise any dispute over the same rules.
Date:

Date

Month

Year

Signature of candidate
* SC/ST candidates will have to submit the Category Certificate

INDIRA GANDHI NATIONAL OPEN UNIVERSITY


ACKNOWLEDEGEMENT CARD

Dear Student,
Thank you for joining MBA Financial Markets. We acknowledge the receipt of your
Application Form. Please mention Enrolment Number and course applied for in all your
correspondence with the University. To be filled in by the Students:
For Office Use Only
Program Applied for: ______________________
Your Enrolment number is

DD Number: ____________________________

..

DD Date: _______________________________

Amount: _______________________________
Bank: _________________________________

BTI ET IDENTITY CARD


Enrolment No
Name of Program
Name
Fathers/Mothers/Husbands Name
..
Address (in Capital Letters) .
..

PASTE
LATEST PHOTGRAPH
TO BE PASTED WHICH
WILL BE ATTESTED BY
UNIVERSITY OFFICE

..
..
Pin code .
Full Signature of the Candidate
..

ATTESTED BY
Session / Date ..

Please mention your full postal address at the space allocated


To,
__________________________________
__________________________________
__________________________________
CITY: _____________________________
STATE: ____________________________
__________________________________
PIN

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