ADARSH MANAGEMENT INSTITUTE OF INDIA

Registration Form

Govt.Regd.No.Mah-786 Mumbai-F-12811

An ISO 9001:2000 Certified International B-School

Photo
Registration Form No: ____________________

Name: _____________________________________________________________________________________________
First Name Middle Name Last Name

Father’s/Husband Name:
____________________________________________________________________________________
First Name Middle Name Last Name

Gender: Male Female

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

Admission to: _____________________________________________________________________________________

Specialization: ___________________________________________________________________________________

E-mail ID: _________________________________________________________________________________________

Address: ___________________________________________________________________________________________
______________________________________________________________________________________

Telephone No: ____________________________________________________________________________________

Nationality: _______________________________________________________________________________________

Academic Qualification:-

Degree/Diploma Name of the Year of Specialization Percentage/Grade

institute/University Passing

PastExperience:____________________________________________________________________________________
____________________________________________________________________________________________________
___________________________________________________________________________________________________

Exam Option: - Online Offline

Fees Paid: - Cheque/D.D/Cash: ___________________________________________________________________

Date: ___________________ Student’s Signature: ___________________

Xerox Copy of marksheet and certificates in proof of all examination passes should be attached.
The application form along with the bank draft should be send to the institute through courier/speed post.
For more then one application Xerox copy of this application proforma can be used.
Please keep a Xerox copy of this application proforma for your record and reference.
Your Information is sent directly to the institute.
Once The fees paid will not be refunded.

Format no: F-AMII-SM-01

Rev.No: 00

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