LAL BAHADUR SHASTRI INSTITUTE OF MANAGEMENT, DELHI

ADMISSION FORM 2019-21

1. Course: Two Year Full-Time PGDM (General) / PGDM (Finance)
PGDM(R&BA) / PGDM (L&SCM)
2. File No. ___________/2019 (For Office Use).

3. LBSIM Enrolment No.: LBSIM/PGDM(___)/ (FT) /2Y/_________/2019 (For Office Use).

4. Name of the Student ______________________________________________________

6. a) Father’s Name _____________________________ Occupation __________________

Mobile No : _____________________ Email :________________________________
b) Mother’s Name_____________________________ Occupation __________________
Mobile No: ______________________ Email: ________________________________

7. Category: General Corporate Sponsored Kashmiri Migrant

8. Aadhaar Card No. _________________________ Date of Birth _____________________

9. Mailing Address ___________________________________________________________

________________________________________________________________________

Tel. _____________________________ Mob. No. ______________________________

E-mail___________________________________________________________________

10. Permanent Address________________________________________________________

________________________________________________Pin Code________________

Tel. _____________________________ Mob. No. _____________________________

11. Graduation Qualification: ____________________________________________________

University __________________________________________________________________

Year of Passing _______________________ Percentage of marks (if completed) _______

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 LAL BAHADUR SHASTRI INSTITUTE OF MANAGEMENT, DELHI
Two Year Full – Time PGDM (General) / PGDM (Finance)/ PGDM (R&BA) /
PGDM (L&SCM) : 2019-2021
Name of the Student _____________________________________________________________
CAT /GMAT Registration No. _____________________________________________________

VERIFICATION LIST
The following documents are verified: Pending Documents :
1) Adhaar Copy
2) CAT/GMAT Score Card
3) Marks Sheet & Certificate: X & XII Standard
4) Graduation Marks Sheet: I / II / III / IV / V / VI / VII / VIII
5) Graduation Provisional & Degree
6) Medical Fitness Certificate from MBBS doctor
7) Annexures I & II
8) Photograph - 3
9) Soft Copy of certificate to be sent at certificate@lbsim.ac.in
10) Other Admin Staff
Date:
The above documents are verified and please accept the fees
NEFT / RTGS / DD

Tran Nos : ____________________

Bank :
_______________________

Receipt No. ___________________

Date :
________________________
(Sachin Khera) (Col Ajay Sood)
Administrative Officer Chief Administrative
Officer (S.P. Kaushik)
Finance Officer
UNDERTAKING
I undertake to attend the classes regularly in each Trimester as per requirements of the Rules and
Regulations of the Institute. In case I fail to fulfill this obligation, the LBS Institute of Management
would be within their right to strike off my name from the rolls. I shall also be responsible to see
all the notices put on the Notice Board of the Institute from time to time.

Date:
(Signature of Candidate)
Name: _____________________________________________ File No. ____________________
Course ________________________________________________________________________
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