Bharati Vidyapeeth University

Amplify – Department of Information Technology and

Management
2nd Floor, Architecture College Building, Bharati Vidyapeeth Campus,
Dhankawadi, Pune-411043.
Telephone: +91-20-24368316, 24372867
Fax No.: +91-20-24368718
Email: info@bvuadit.com URL: www.bvuadit.com Form No.:

To,
The Director,
BVU – Amplify – Department of Information Technology and Management,
Bharati Vidyapeeth University,
Photograph
Dhankawadi, Pune – 411 043.

Sir,

I, _____________________________________________________________________
(Write full name in blocks as it appears on Graduation Mark list)

wish to apply for admission to PGD / BSc / M.Sc in _______________________________

course in your institute in the academic year __________.

1. BVU – Amplify – DITM reserves the exclusive right to reject any application without
assigning any reasons thereof.

2. A non-refundable fee of Rs. 1000/- towards Prospectus is payable by every candidate

on registering for admission process.

3. All disputes with regards to admission are subject to the legal jurisdiction of Pune.

4. The information that you provide in the application form will be used by BVU – Amplify
- DITM. You may receive information through email or other form, on matters
unrelated to BVU – Amplify - DITM and you agree not to object to such mailers.

Yours Sincerely,

Place: _____________________ Sign: _________________________

Date: _____________________ Name: ________________________

 Personal Information
(To be filled in Block Letters)

Name in full: _____________________________________________________________________

Father’s Name: _____________________________________ Father’s Qualification: ________

Permanent Address: Building Name: _______________________________House No.:________

Street: ______________________________ Landmark:____________________________________

City:________________________________ Pin : __________________ State: ________________

Phone No. (__________) __________________ Mobile No. ________________________________

Correspondence Address: Building Name: _______________________________House No.:____

Street: ______________________________ Landmark:___________________________________

City:________________________________ Pin : __________________ State: ________________

Phone No. (__________) __________________ Students Mobile No.: - ____________________

Email ID: _________________________________________________________________

Date of Birth: ________________________ Birth Place: _______________________________

(As per school leaving certificate)

Married / Unmarried: ______________________________ Gender: Male / Female

Mother Tongue: ___________________________ Nationality: ___________________________

Religion: ________________________________ Category: _____________________________

Hostel Required: Yes / No (Please tick appropriate option)

………………………………………………………………………………………………

Information of Parents

Mother’s Name: ________________________________________Mother’s Qualification: ______

Father’s Occupation: ___________________ Mother’s Occupation: _______________________

Father’s place of employment: ____________________________________________________

Mother’s place of employment: ____________________________________________________

Annual Income of Parents (from all sources in Rs.): __________________________________

 Academic Information

Month , Medium
Name of School Board /
Exam Specialization % Year of of
/ College University
Passing Teaching

S.S.C.
-------------
(Xth Std.)

XII th / Pre.
University

Graduation

Post
Graduation

Entrance Test Appeared: CAT / MAT / AMCET / XAT / ATMA / _________________________

Composite Test Score: ________out of _______ Percentile: __________________________

How did you come to know about BVU – Amplify – DITM? ________________________________

All the information mentioned above is true as per my knowledge.

Place: _____________________ Sign: _________________________

Date: _____________________ Name: ________________________

……… (All Entries beyond this for Office Use Only) ……

1) Candidate’s Skills :(Rating on a scale of 1 to 5, 1 is LOW and 5 is HIGH)

School / College Background :

Communication Skills:

Presentation Skills:

Body Language :

Technical Ability:
 2) Should we admit this candidate?

On Hold

No

3) Comments(if any):

Assessed By: _______________________

Signature: _________________________

Admitting Authority Remarks:

ADMITTED / NOT ADMITTED to _____________________________ course.

Signature: ___________________________________
Chairman / CEO / Head Admissions