BHARATI VIDYAPEETH DEEMED UNIVERSITY, PUNE

INSTITUTE OF MANAGEMENT AND

ENTREPRENEURSHIP DEVELOPMENT
(Reaccredited by NAAC with A Grade)
ADMISSION FORM FOR SECOND / THIRD YEAR
Application for Admission to Second / Third Year during 20
Course

Affix your recent

passport size
photograph
(Dont Staple)

- 20

Specialisation

Roll No.

Division

Fees Paid Rs.

Receipt No.

Date

Candidate Information
As it appears on your latest statement of Marks
Student Name

Mr./Mrs./Miss.

PRN.
Father / Husband's Name
Permanent Address

City

District

State

Pin Code

Country

Phone No.with STD / ISD code

Student's Mobile No.

Parent's Mobile No.
Local Address in Pune

Pin Code
Phone No.with STD / ISD code
Emergency Contact No.
Date of Birth
Religion

Sex
Place of Birth
Category

Blood Group
Nationality
Caste/Sub Caste

For PIO or Foreign or NRI student

Passport No.

Date of Expiry

Visa No.

Date of Expiry

Police Registration No.

Date of Issue

Passport Issued by

Date of Expiry

General Information
Students E-mail ID
Parent's' E-Mail -ID
Write which ever is applicable
Self Finance/Or ICCR/ Scholarship/J&K
Achievements in Sports
(In this Institute)
Certificates/Awards won
(In this Institute)
The details of performance at previous Examination
Examination

Seat No.

SGPA

CGP

Semester -I
Semester -II
Semester -III
Semester -IV
(Please attach Photo copies of Marks statement)
Mention the elective functional subject area chosen for Second/Third year :
Furnish following details
i) Title of Summer Project
ii) Name and Address of the Organisation
iii) Duration (Give exact dates) from

To

iv) Skill sets acquired or nature of the work handled

v) Additional training courses/programmes completed
vi) Job areas preferred

DECLARATION FROM THE CANDIDATE

a) I declare that, I have read all the rules of admission and after understanding these rules I have filled the form for admission for
the year 20
- 20
. b) I shall submit Examination form for the concerned examination, if found eligible, within stipulated
dates announced by University. c) I shall abide by the decision of the University in all the matters concerning eligibility, courses
of study. I shall attend minimum 75% of the lecture and practical's and will be observing all rules and regulations of the Institute
and University that will be in force form time to time.
d) I know if my attendance in class, practical's is below 75% in the
semester, my examination form will not be accepted. e) I hereby agree to confirm to the rules and regulation made for the
governance of the Institute. f) I fully understand that the Dean/Director of the Institute where I am studying will have full liberty
to expel me form the Institute for any violation of the rules, eligibility condition and policies as laid down by the Institute. The fee
is accepted by the Institute subject to the condition that I will pass the qualifying examination for admission to _____________
failing which amount will be adjusted as and when I qualify the same.

Date :
Place :

/ 20

Students Signatur

Admitted provisionally / Not admitted

PROGRAMME DIRECTOR
Date :
/
/

(For Office Use)

DECISION

ACCOUNT SECTION
Date :
/
/

ELIGIBILITY SECTION
Date :
/
/

DIRECTOR
Date :
/
/