Application Form: PGDM Global MBA Ph.D.

(Passport size photograph of the candidate)

Instructions: a. All details to be filled in CAPITAL letters only. b. Use separate sheet to provide additional information not captured in the application

Personal Details:

Full Name (as per certificates):

Phone number:

Alternate Phone number:

Email ID:

Date of Birth: / / (dd/mm/yy)

Gender: Male Female

Nationality: (Passport size photograph of the candidate)

Present Address for communication:

Permanent Address:

Father’s Name:

Occupation: Contact No. :

Mother’s Name:

Occupation: Contact No. :

Academic Details (Please attach scanned copies):

Competitive Exam appeared for: CMAT / MAT / NMAT / CAT / GRE / GMAT / XAT / Others

Registration Number: Score:

Academic scores and details:

Percentage or CGPA

Professional details (Please attach scanned copies):

Joining Date

Relieving Date

No. of months

worked

Other Information:

Additional Information: (Extracurricular Activities / Achievements / Honors / Hobbies)

Indicate your preferred city for personal interview:

Skype ID:

Statement of Purpose (SOP) (can be submitted a week before the personal interview) Write and attach an essay about yourself, your career goals. Be sure to highlight the following aspects: (Word lim2000) a) Evidence of leadership b) Motivation and drive c) Overcoming adversity (including disabilities) d) Personal qualities

Requirement of Campus Accommodation: YES NO

Room Preference: Single Sharing

Specialization Interested in: Marketing and S

Source: Direct Others

Names of other B schools (India/Aboard) where you are seeking for admission:

DD should be in favour of Mysore Royal Academy, Payable at Mysore E-remittance: State Bank of India, Commercial Branch, Mysore, A/C No.:31409573150 IFSC code: sbin0004161