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Please send this Application Form along with 1)Demand Draft for Rs.

1,200 towards cost of IBSAT 2011 Application Material (demand draft should be drawn in favor of "IUCF A/c IBS" payable at Hyderabad) to The Admissions Officer, IBSAT Office, #52, Nagarjuna Hills, Punjagutta, Hyderabad-500082

IBSAT 2011 ONLINE APPLICATION FORM ( DECEMBER 24, 2011) Application No.752273
Name of the Applicant (Use CAPITALS ONLY) Application No. Test Center (Code) Indian Citizen ROHIT CHAUHAN

752273

Chandigarh(Sector 18 B) (109)
Yes

Gender Male

Medium of Instruction ( English ) Y/N

Class X

Yes

Class XII Yes

Degree Yes

Date of Birth (DD/MM/YEAR) Academic Record

02

04

92

Agg. Marks (%) Class X Class XII 46.20 61.00 Duration of Mode of Study Course (No. of Yrs) Regular 3 Years

Year of Passing 2007 2009 Year of Passing 2012

Qualification (Code) Bachelor's Degree P.G Qualification Professional Qualification

Status Final Year

Agg. Marks (%) 65.25

BBA/BBM/BBS(23) -

Program Applying

MBA / MBA(FE) / PGPM #966,SECTOR- 70,MOHALI DISTT-MOHALI PUNJAB Mohali 160071 Mobile 9876686167 E-mail Address 2 State (Code)

Address (full postal address) City Pin code E-mail Address 1

Punjab

(22)

ROHIT_CHUAHAN1036@YAHOO.COM 10/4/2011

Place: Mohali Date: (MM/DD/YYYY) Print

_______________________ Signature of the Applicant

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