LLOYD

INSTITUTE
OF
MANAGEMENT
&
TECHNOLOGY

LLOYD GROUP OF INSTITUTIONS

Plot No. 11, Knowledge Park-2, Greater Noida
Email lloydadmissions@lloydcollege.in | www.lloydmanagement.edu.in/
Helpline No. : +91-9821891830

REGISTRATION CUM ADMISSION FORM

1. Please fill the form neatly Reg. No.:
2. Incomplete form will not be accepted
Master of Business Administration (MBA)
Affiliated to AKTU Approved by & AICTE, Ministry of HRD, Govt. of India, New Delhi

Entrance Exam. Branch Applied for

CAT Score................ / Percentile ................ Marketing IT
MAT Score................ / Percentile ................
Finance IB
XAT Score................ / Percentile ................
CMAT Score................ / Percentile ................ HR Operations

Name of the Student in Full (Block Letters):

A D I T Y A K U M A R R A I
FIRST NAME MIDDLE NAME LAST NAME
Permanent Address
V I L L - M O T I P U R , P O S T - M A H U W A
D I S T R I C T - G O P A L G A N J
P I N C O D E : 8 4 1 4 3 7
State: PIN:
B I H A R 8 4 1 4 3 7
Res. Telephone No. (With STD code) Mobile No.
9 5 4 6 4 5 8 8 6 3
Correspondence Address (if different from above)
V I L L - M O T I P U R , P O S T - M A H U W A
D I S T R I C T - G O P A L G A N J

State: PIN: Mobile No.

B I H A R 8 1 4 1 3 7 8 8 7 4 2 0 1 9 7 3
E-mail ID :
a d i t y a r a i n @ o u t l o o k . c o m
Nationality: Marital Status: Gender:
I N D I A N Married Single Male Female

Date of Birth: dd 04mm 0 6 yyyy 2 0 0 0 State of Domicile: B I A H R

Religion: H I N D U

Category: Gen SC/ST/OBC Others

Page No. 1
 ACADEMIC QUALIFICATION

Board / Regular/Private/
Name of Exam. Year Subjects
University Distance Education Mode
High School / HINDI, ENGLISH
Secondary BIHAR BOARD 2015 REGULAR
MATHEMATICS, SCIENCE,
SOCIAL SCIENCE, SANSKRIT 59 %

Intermediate / PHYSICS, CHEMISTRY,

Sr. Secondary REGULAR MATHEMATICS, ENGLISH,
HINDI

Graduation RAVINDRANATH TAGORE RETAIL &

Specify: UNIVERSITY 7.5 CGPA
BHOPAL MARKETING

Any Other
Specify:

Name of Father in Full (Block Letters):

C H A N D E S H W A R R A I
Occupation Designation
F A R M E R N / A
Name of Organization
N / A
Address of the Organization
V I L L - M O T I P U R , P O S T - M A H U W A
City: G O P A L G A N J
State: PIN:
B I H A R 8 1 4 1 3 7
Father Mobile No.
9 5 4 6 4 5 8 8 6 3
Annual Income (appx.)
9 0 0 0 0 I N R
E-mail ID:
N / A

Name of Mother in Full (Block Letters):

M A D H U R E E D E V I
Occupation
H O M E M A K E R
E-mail ID:*
N / A

Page No. 2
Details of Brother(s) / Sister(s) / any other Blood Relation studying/has studied at Lloyd College (if any):

Name: N / A N / A

Course: N / A

LOCAL GUARDIAN DETAILS

Name in Full (Block Letters):

N / A
Address:
N / A

N / A City: N / A
*to update you about the Institute

State PIN:
N / A N / A

Mobile No.
N / A N / A

E-mail ID:
N / A

Relation with the Applicant:

N / A

Laptop Yes No Study Tour Yes No

Study Material Yes No Additional Courses Yes No
Transport Yes No Hostel Yes No

Work Experience Details

Organization & Address
M A R K A B L E S O L U T I O N P V T . L T D .

Designation
B R A - V O I C E

Duration of work from 0 1 / 2 0 2 1 to P R E S E N T

BUSINESS RESEARCH ANALYST FOR PAST 1.5 YEARS FOR MARKABKE SOLUTION PVT. LTD.
Job profile: .............................................................................................................................................................

.................................................................................................................................................................................

.................................................................................................................................................................................

Page No. 3
 I hereby declare that I have read and understood all the rules and regulations of the Institute. I will fully abide by the rules and regulations
of the Institute during the course of my studies, otherwise my admission can be cancelled or any other disciplinary action can be taken
against me.
I hereby declare that the particulars stated above are true to the best of my knowledge and belief.
The admission is purely provisional subject to fulfillment and verification of all the certificate and students made by me in the
admission from and in compliance with the AKTU & AICTE requirements. In case my admission is not approved or cancelled by the
Competent Authorities, then the Institute will not be liable for the same and I will not claim any fee refund.
I understand that I have to pay my fees as per the Institute's schedule or I can be debarded from exams/placements opportunities.
I shall not claim a refund of registration fee at any time.

Date

I, Mr. / Ms.............................................................F/o/ M/o / G/o assures that my ward. .................................................................... will strictly
abide by the rules and regulations of the institute during the period of his / her studies, otherwise his / her admission can be cancelled,
and / or any other disciplinary action by the authorities of the institute will be acceptable to me.

Date

(course)

Date

LLOYD.

How did you come to know about LLOYD and its admission process?

Through prospectus of CAT/XAT/MAT/CMAT etc. Through mass media/magazine/electronic

Through friends and relatives Through a student of LLOYD

Through Coaching Center / Career Consultant ........................................................................................................................

Verified by: (Admission officer) .....................................................

Page No. 4
 ESSAY WRITING:
Write in 100-150 words the reason why you want to persue management higher education, and how will it help in
achieving your goal in life?
In my village where I grew up as a child, every time an airplane flew over our houses
was a celebration. The children and elderly, equally curious to spot the object
would fix their gaze in the sky and wait for the airplane to fly over. Since childhood
I’ve dreamt of soaring high as did the latter.
Being curious about the world of commerce and business , I enthusiastically involved
myself in various projects in schools and later on in my university as well, this only
intensified my curiosity and helped me delve into the different aspects of markets &
businesses . The most interesting aspect of marketing which I love is its ability to
cater to a wide variety of today’s needs. The presence of scenario based problems
adds an extra dimension to my love for the subject and gives me a keen insight into
another favorite subject of mine: operation of businesses.
Adding to this, the practical side of the subject has always compelled me to participate
in different activities conducted by various organizations such as; PaisaBazaar.com,
Doubletree by Hilton.
Growing up, I read the autobiography of my role model Warren Buffet, and realized
that this was the field of study that intrigued me most.
I have closely worked with my school administration and University administration in
organizing various celebrations in the respective institutes. This has helped me to
refine my innate management and leadership skills.
I am a very resourceful and responsible person. I believe that self- discipline, the zeal
to learn and good verbal and written communication skills are of utmost importance to
be a successful individual.
I trust that these qualities will enable me to make my dream come true and be a part of
the management world.

Page No. 5
 DOCUMENTS CHECKLIST
Ensure you have attached the photocopy of following documents copies before submitting your application form:

1. Four Passport size Photographs

2. Certificate and Mark Sheet of 10th

3. Certificate and Mark Sheet of 12th

4. Bachelor's Degree and Mark Sheet

5. Cast Document

6. Migration

7. Aadhar Card

8. Address Proof (Passport / Pan Card)

9. CAT / MAT / XAT / (Scorecard)

11. Experience letter, if applicant has worked for more than one year.

Documents verification

Submitted by: Received by:

Student's Name, Admission Manager's Name,

Signature & Date Signature & Date

Verified by

Page No. 6
 What are your two strengths and weaknesses? Please Explain

Strengths:
1.

2.

Weaknesses:
1.

2.

Page No. 7
 Evaluation Sheet - Date:

STUDENT NAME SPECIALIZATIONS APPLIED FOR:

GROUP DISCUSSION

/ 20

WRITTEN TEST/ ONLINE TEST (L MAT)

/ 30

Faculty 1 (Name) Faculty 2 (Name)

PANEL ROUND

PARAMETERS MARKS FACULTY 1 FACULTY 2 REMARKS

Personality 5

Clarity of Goals 5

General Awareness 5

Academic Knowledge 5

Communication Skills 5

Body Language 5

FINAL ROUND/ DIRECTOR'S ROUND

PARAMETERS MARKS REMARKS

Personality 5

Clarity of Goals 5

General Awareness 10

Academic Knowledge 10

Communication Skills 10

RECOMMENDATION SIGNATURE:

TOTAL SCORE / 150

Page No. 8