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Mba Mca
Mba Mca
COIMBATORE INSTITUTE OF MANAGEMENT AND TECHNOLOGY
(Approved by AICTE, Ministry of HRD, New Delhi)
(Affiliated to Bharathiar University, Coimbatore)
Narasipuram Post, Thondamuthur Via., Coimbatore – 641 109.
Phone : (0422) 2650131, 2650132, Fax : (0422) – 2650427
(An ISO90012000 Certified Institution)
APPLICATION FORM FOR ADMISSION TO MBA/MCA DEGREE COURSE
1. Name : Space for affixing
(in block letters with initials at the end) Passport size
photograph
Address for Communication :
Age (Completed Years) :
Place of Birth :
Village/Town/City District State
4. Community (3) : ST SC MBC/DNT BC FC
6. Mother Tongue :
7. Qualifying Examination
Name of the Month/year
Institution / University Duration % of Marks
Degree Passing
(Enclose only attested true copies of mark sheets. At the time of admission original certificates should be furnished)
8. Extra Curricular activities :
9. Particulars regarding Parent / Guardian :
a. Name and Residential Address :
b. Occupation and Office Address :
c. Annual Income : Rs.
I declare that all the information stated above are correct and true to the best of my knowledge. I agree to be
governed by the rules & regulations of the college as in force and as may be revised from time to time.
Place :
Date : Signature of the Applicant
Payment Details