072211766478178

MBA (MM)
Date: 11-07-2022

NMIMS GLOBAL ACCESS-SCHOOL FOR CONTINUING EDUCATION

Admission Form

Registration No: 072211766478178

Personal Details

Salutation: Mrs. Name: Pranati Das

Date of Birth: 02 / 06 / 1993 Gender: Female

Marital Status: Married Father's name: Udaya Nath Das

Mother's Name: Nalini Das Spouse Name: Survanshu Saxena

Blood Group: B+ Category: OBC

Other Blood Group: Nationality: Indian

Domicile: India Batch Name: July2022

Address of Communication

Billing Address: 352, Pashchim Puri Shastri Puram Permanent Address: 352, Pashchim Puri Shastri Puram

Road Agra Uttar Road Uttar Pradesh Agra India

Pradesh India 282007 282007

Shipping Address: 352, Pashchim Puri Shastri Puram

Road Uttar Pradesh Agra India STD Code:

282007

Mobile Number: 9439894287 Primary Email: pranati0501@gmail.com

Alternate Email: Phone Number: 9439894287

 072211766478178
MBA (MM)

Academic Information

SSC/10th %: 80.00 SSC/10th Board: State Boards/Others

Attabira Govt Girls' High

Year of Completion(10th): 2008 Name of School(10th):
school, Attabira

Diploma / 12th: XII/HSC

HSC/12th %: 76.83 HSC/12th Board: State Boards/Others

Year of Completion(12th): 2010 Name of School(12th): Attabira College, Attabira

Physics, Chemistry, Math,

Stream (12th):
Biology, English, Hindi

Botany, Zoology, Chemistry,

Bachelors Degree Name: Bachelor of Science Specialization:
Education

Regional Institute of

College Name: Education, NCERT, University Name: Utkal University

Bhubaneswar

Bachelors Degree %: 79.73 Graduation Degree Mode: Full Time

Year of Completion: 2014

Work Experience:

Total Work Experience: Industry : Others

Company Name: Sysmex Corporation Department: R&D

Designation: R&D associate

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MBA (MM)

Program Details

Program Name: MBA (Marketing Management)

Eligibility: Bachelor with 50%

Information Center

Information Center: Agra - Sanjay Palace

Declaration

I hereby declare that the information furnished by me in the Admission form is true and correct to the best of my

knowledge. I am aware that my candidature and/or admission at NGA-SCE (July2022) and subsequent process can be

cancelled unilaterally by NMIMS at any stage if the information furnished by me is found to be incorrect and in such a

case all the fees paid by me will be forfeited and will not be refunded to me.

Date : 11/07/2022 Signature :

Place : None