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Yashwantrao Chavan Maharashtra Open University

Application Form for MBA. 2014-15 Admission Process
Version No. : 1.0
Form No: 100001309
/ Name : Mr. Malvi Ashishkumar Jairaj
Candidate Photo
Candidate Sign
/ Father's Name : Jairaj / Mother's Name : Chandrakala
/ Gender : Male
/ Date of Birth : 05 Feb 1986
/ Address :
At Gaurala Ward 12 Bhadravati Tah Bhadravati Dist
Chandrapur, City- Bhadravati, Taluka- Bhadrawati, District-
Chandrapur, State- Maharashtra. Contact No: --, MobileNo-
9096958459, EmailId- ashishnfsc@gmail.com.
:: / Reservation Category Details
/ Reservation Category : ST - | / Caste Name : Pardhan
/ Domicile of : Maharashtra
Note : Please ensure non creamy layer certificate is applicable for some specified reserved categories and such candidate is
eligible for relaxation in percentage at graduate level, only if he/she possesses valid non creamy layer certificate.
:: / Social Reservation Details
? / Physical Handicapped : No
? / Ex-ServiceMan : N
Exam Center Name- Anushree Computech Pvt.Ltd
City-Chandrapur, District- Chandrapur, Date- 27/07/2014 & Time- 01:00 PM To 02:30 PM
:: / Degree Information
S.N. Faculty Program Specialization Board/University Month-Year of Passing Class %/Grade
1. Arts Graduation BA Nagpur University
December
2012
Second 51.40
:: Declaration
I have read and understood eligibility condition and I fulfill the educational qualification and the percentage of marks
required at graduation for admission to MBA programme.
1.
I shall produce all the original documents along with attested copies at the time of admission. I know that required
educational qualification and passing the entrance test is essential condition for admission to MBA programme.
2.
In case any particulars given by me in this application are found to be false, incorrect and/or misleading, I shall be liable for
the necessary action by university Dated Signature of candidate.
3.
I have secured 45% or more percentage in Graduation ( for Open category) or 40% or more percentage in Graduation (
For Reserved category)
4.
No photocopy of certificate shall be attached with this form. This form shall be submitted at examination centre duly signed.
Place :
Date : 7/8/2014 2:58:40 PM
Signature of Candidate
(Mr. Malvi Ashishkumar Jairaj)
YCMOU MBA. Admission 2014-15 Application Form... http://oasis.mkcl.org/ycmoumba2014/AppForm/PrintApplicationForm...
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Yashwantrao Chavan Maharashtra Open University
MBA Entrance Examination
Hall Ticket
Form No.: YMBA14100001309
Candidate Photo
Candidate Sign
Name: Mr. Malvi Ashishkumar Jairaj
Exam Centre:
Anushree Computech Pvt.Ltd,
Address-C/o.: Arts, Commerce &
Science College, Tadoba Road, Tukum,
City-Chandrapur, District- Chandrapur
Date and Time of Examination: 27/07/2014 & 01:00 PM To 02:30 PM
Instructions:
1. Application Form shall be submitted at exam center.
2. Candidate shall report the exam centre half an hour before the scheduled time for pre exam formalities. Candidate shall bring
valid Id proof to verify the identity.
Signature of Candidate
Jul 8 2014 2:53PM
Date
(Mr. Sunil Khairnar)
Controller of Examinations
YCMOU MBA. Admission 2014-15 Application Form... http://oasis.mkcl.org/ycmoumba2014/AppForm/PrintApplicationForm...
2 of 2 08-07-2014 14:59