Printed On : 02-May-11

Session: 2011

Admission Id : 10016

Course: MBA-LaterEntry Semester : 3 Telephone

Number (If Any ): 01812680029
Name : Shivender Sharma Mobile (If Any) : 97834414
Father /Guardian Name : Rajinder Parshad
Nationality : Indian
Date Of Birth : 10/16/1985 Employed : Yes
Gender : Male Marital Status : UnMarried
Email : shivenderempire@gmail.com

Correspondence Address : Near Darshan di Chakki,V.P. O Mithapur Permanent Address : Near Darshan di Chakki,V.P. O Mithapur

City : Jalandhar City : Jalandhar

District : Jalandhar District : Jalandhar

State : Punjab State : Punjab

Country : India Country : India

Pin Code : 144022 Pin Code : 144022

Qualification Details :

Qualification Main Subject Session Percentage Board

10Th NA 2000 65 PunjabSchoolEducationBoard
12th NonMedical 2002 70 PunjabSchoolEducationBoard

Fee Details : Fee Amount Fee Receipt No Fee Bank Fee Payment Date
5000 1223456123 State Bank Of india 01 Jan 1900
Check List :
Eligibility result status : PASS RE-APPEAR AWAITED

Certificate Attached: Matric 10+2 Graduation

Diploma Post Graduation Any other (Please Specify)

Photo signed By Candidate Attested Copy of Bank slip Attached

Attested Photo : Nos. Student Profile : Private Sector Employee

I Shivender Sharma Son/Daughter of Rajinder Parshad am seeking admission to MBA-LaterEntry course on provisional basis due
to___________________________, I hereby agree that in case I am not able to fulfill the eligibility criteria before stipulated time as per
norms, my candidature for the said course would stand canceled an I shall not be entitled to refund of any fee paid by me. The University
reserves the right to no declare result of my semester examination untill I submit my certificate of clearance of eligibility.

Name/ Signature of Candidate

I hereby declare that I have been read the prospectus thoroughly and understood the conditions of eligibility for the programme for which I
seek admission. I fulfill the minimum eligibility criteria & I have provided necessary information in this regard. In the event of any
information being found incorrect or misleading , my candidate shall be liable to cancellation by the University at any time and I shallnot be
entitled to refund of any fee paid by me.
Date :___________________ Place :___________________ Name/ Signature of Candidate