INDUS BUSINESS ACADEMY

APPLICATION FORM
APPLICATION NO:
IBA/2023/1481

Basic Details
Program Details
Program PGDM Program

Source Of Information Iq Factor

Personal Details
Title Mr.

First Name Amit

Last Name Bhattacharjee

Primary Email greatamit2001@gmail.com

Alternate Email subhankar1234@gmail.com

Mobile Number +91-7477360375

Gender Male

Date Of Birth 07/10/2001

Age As On 31 January 2023 21 years , 3 months , 24 days

Blood Group O+

Differently Abled No

Family Income 4-8 lakhs

Nationality Indian

Religion Hindu

Category General

Aadhaar Card Number 893950889197

Marital Status Single

Father's Details
Father Title Mr.

Father Name Arup Kumar Bhattacharjee

Father Mobile Number +91-9735100976

Father Occupation Business/Self - Employed

Name Of The Organization

Designation

Mother's Details
Mother Title Mrs.

Mother Name Rupashri Bhattacharjee

Mother Mobile Number +91-9735100975

Mother Occupation Home maker

Name Of The Organization

Designation

Address Details
Address For Correspondence
Country India

State West Bengal

District Bardhaman

City Bardhaman

Address Line 1 5 no Ichlabaad

Address Line 2

Pincode 713103

Is Permanent Address Same As The Address For Correspondence? Yes

Xth Details
School Name Board Year of Passing Grading Scale Maximum Marks Obtained Marks / CGPA Percentage

Burdwan Town School West Bengal Board Of Secondary Education 2018 Marks 700 457 65.29

XIIth Details
School Name Board Stream Year of Passing Grading Scale Maximum Marks Obtained Marks / CGPA Percentage

West Bengal Council Of Higher Secondary

Burdwan Town School Humanities 2020 Marks 500 445 89
Education

Graduation Details
Mode of Delivery: Regular

Obtained CGPA /
Institute University Course/Stream Year of Passing Grading Scale Maximum Marks Percentage
Marks​​

cyber research and training Burdwan University, West

BCA 2023 CGPA out of 10 9.4
institute Bengal

Other Professional Course Details

Have You Completed Or Perusing Any Professional Course Such As
Course Name Name Of The Professional Body Completion Status Of Professional Course
CA/GNIT/ICWA ?

Year Of Completion

Work Experience Details

Please Input The Work Experience Details In Chronological Order Starting From The Most Recent Job. Employees Reporting To You & Annual Salary (In Lakhs), Only
Numbers Are Allowed. If You Are Currently Working, Please Enter The Current Date As End Date.

Work Experience ​No​

Declaration
I Hereby Certify That The Particulars Filled By Me In All The Sections Of This Application Form Are True To My Knowledge And Belief. I Certify That I Fulfill The Eligibility
Criteria Of IBA. I Understand And Agree That Any Mis-Representations, False Information Or Omission Of Facts In My Application Will Lead To Denial Or Cancellation Of
Admission At Any Stage Of The Program. I Understand All Disputes Will Be Subject To Territorial Jurisdiction Of City Of Bangalore Only.

Applicant Name Amit Bhattacharjee Parent Name Date 05/04/2023

Upload Photo & Signature

Upload Passport Size Photo

Upload A Copy Of Your Signature

Upload Xth Marksheet Yes

Upload XIIth Marksheet Yes

Upload Graduation Marksheet Yes