MAT Feb-2019 Registration Form

Registration No.

* Opted Test Mode Paper Based Test (PBT)

* Test Date 17 February 2019 (Sunday)

* Test Timing 1000 To 1230 Hrs

* Test Centre City for Paper Based Test Test City Choice 1. ANDHRA PRADESH : VISAKHAPATNAM
(PBT) Test City Choice 2. ORISSA : BHUBANESWAR

Personal Particulars
* Name of the Candidate Mr. Penta Sriramulu

* Father's Name Penta Srinivas Rao * Mother's Name Penta Gowri

* Date of Birth 14-Sep-1997 * E-mail ID pentasriram97@gmail.com

* Gender Male * Category General

* Nationality Indian

* Address for Communication Sri Rama Jewellery ,

Main Road,
Jeypore, Odisha, 764001

Contact Number (Telephone no.) with STD 06854 233703 * Mobile No.+91- 9040610182
Code

* Are you a Person with Disabilities NO

(PWD)?

* Photo ID to be produced at test centre Aadhar Card * Photo-ID No. 874193890553

Qualification & Experience Details

* Qualification Name * Percentage of Marks * Status of Qualification * Stream/Discipline

10+2 44.83 % Passed NA

Bachelor In Commerce - Appearing in Qualifying Exam Commerce

Experience in Months

* Have you earlier appeared in GMAT - NO CAT - YES XAT - NO

Payment Details
Transaction Reference No. Payment Date Receipt No/ PG Ref.No. Amount

4469228547 08/02/2019 23:12:53 PHMP7197005522 1550.00

Declaration
I here by affirm that the particulars filled by me in this form are true and correct. I have read and understood the terms and
conditions of the test and agree to abide by those.
Registration No. 836791

Signature of Candidate

You are NOT required to send Registration Form/any documents/receipt to AIMA. Candidate can view/download the MAT
Prospectus from AIMA website. No separate Prospectus/CD will be dispatched.
 MAT Feb-2019 Registration Form (Part II)
Options for Management Institute Choice
Registration No. 836791

Name of Candidate Mr. Penta Sriramulu

Date of Birth 14-Sep-1997

Management Institute Choice Code :

* Choice 1 5016-Vignana Jyothi Institute of Management : Hyderabad

* Choice 2 5003-Institute of Insurance and Risk Management : Hyderabad

* Choice 3 5033-Hyderabad Business School : Hyderabad

* Choice 4 5001-Dhruva College of Management : Hyderabad

* Choice 5 5011-Aurora's Business School : Hyderabad

You may Change/Modify the MI Choice Option filled by you, by logging in at the website https://mat.aima.in/feb19 upto 23 February 2019.