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Application for Admission to
M.B.A./M.Tech./M.Phil. (4 Semesters) Degree
Programme
First Semester 20152016
If you have already submitted this form, but failing to download the application form or challan, then please click here to continue
Note : Fields Marked with an asterisk * are compulsory.
Applicant's Personal Details
Programme* Select Programme
From where did you FIRST learn about WILP Programmes?* Please select
Date of Birth* DD MM YYYY
Gender* ..
(As it appears in
Your Name*
degree certificate)
Reenter your Name*
Father's Name*
Mother's Name*
Nationality* Nationality
Applicant's Communication Details
Address for correspondence*
City*: PinCode*:
State*: State
Country* India
Phone Number
Mobile Number (Enter only 10 digit mobile number. Do not add "0" or "+91")
EmailId*
Applicant's Employment Details :
Current Employment Status* Select Employment Status
Will your employer give consent for you to do the BITS Select
degree*
Select One (This centre is for writing examinations, once you enrolled in the
Your Exam Centre Choice*
programme)
Name of Employing Organization*
Location of Employing Organization*
Employee Number
Designation*
Who will pay your fees? ..
Type of Industry of employing organization * Select Type of Industry
Date of Joining your present Organization* DD MM YYYY
Total Work Experience (as on June 20, 2015 to be counted
only from the point of completing qualifying degree i.e. B.E. / Year Month Day
M.Sc. or equivalent) *
Previous Work Experience: Since the year of completing BE / MSc or equivalent, give brief employment details below in reverse chronological order
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5/24/2015 :. WILP BITS MTech/MBA/MPhil Admissions .:
1 DD MM YYYY DD MM YYYY
2 DD MM YYYY DD MM YYYY
3 DD MM YYYY DD MM YYYY
4 DD MM YYYY DD MM YYYY
5 DD MM YYYY DD MM YYYY
Applicant's Educational Details :
Year of % of
Degree Discipline Duration
Passing
Name of Board / University
Marks
Division
Class X or equivalent
Class XII or
Discipline ..
equivalent
BSc or equiv. Discipline .. ...
BE, MSc or equiv.
Discipline .. ...
*
Indicate the Level at which you have studied Mathematics* Select
Have you ever been a student of BITS, Pilani?* Select
If yes, Please write your Identification (ID) Number
Are you currently enrolled for pursuing some degree or diploma from any other University* Select
Applicant's Mentor Details :
Name of Mentor*
Mentor Qualification*
University
Specialization / Branch*
Designation of Mentor*
Name of Organization*
Mentor Address
City*
State*
Mentor's email address*
Mentor's contact phone number
Submit Reset
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