NO.

2011/

1.

APPLICATION FORM
Programme Applied For:
(Please tick in the relevant box. or in case you have applied for more than one programme, give relevant preference of ranking)
(Please me ntion the preference)

[1]

Under Graduate Programmes

[2]

BA (Hons) in Retail Management with Marketing*** (3 years)

Please affix

Graduate Programme in Retail Business Studies* + BBA** (3 years)

passport size
[1]

Post Graduate Programmes

[2]

[3]

PG Diploma in Retail Management* ( 1 year)

photograph in
the box

PG Diploma in Visual Merchandising and Store Design* (1 year)

PG Programme in Retail and Marketing* + MBA** (2 years)
2. Category (Kindly tick in the relevant box) : General

Company Sponsored

3. Name: ............................................................................................................................................................................................
4. Date of Birth : ...............................................................................................................................................................................
5. a. Father's Name : ..........................................................................................................................................................................
b. Father's Occupation : .....................................................................................................................................................................
c. Fathers Mobile No. ......................................................................................................................................................................
6.a. Mother's Name : .........................................................................................................................................................................
b. Mother's Occupation : ...................................................................................................................................................................
c. Mothers Mobile No. : ...................................................................................................................................................................
7. Family's Annual Income: Rs. 2-5 Lakhs

Rs 6-10 Lakhs

Rs. 10-15 Lakhs

Rs.15 Lakhs & above

8. a. Present Address : .......................................................................................................................................................................

........................................................................................................................................................................................................
b. Telephone No. (with STD code, if applicable) .........................................................................................................................
c. E-mail ID (Applicant's) : ...........................................................................................................................................................
d. Mobile No. (Applicant's) : .........................................................................................................................................................
9. Permanent Address : ......................................................................................................................................................................
........................................................................................................................................................................................................
........................................................................................................................................................................................................

* Autonomous Full Time Programme of IRS ** Degree through Distance Learning from a UGC recognized university *** Degree from University of Central Lancashire

10 a. Local Guardian's Name and Address (in case of out station candidate) : --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------b. Telephone No. (s):-------------------------------------------- Mobile: -------------------------------------------------------------------11. Educational Qualification:
a. Senior Secondary Board Examination

Discipline

Year

Institution

Board

%age

Main Subjects

b. Graduation / Professional
Course

Year

Board/University

Institution

%age

Main Subjects

12. Work Experience (if any)

Organization

Designation

Period

13. Extra Curricular Activities:

14. Special Awards / Merits / Scholarships:

Signature of the Applicant

Signature of Parent / Guardian

Date:.....................................

Date:.........................................

FOR OFFICE USE ONLY

Marks obtained in the Entrance Test ------------------------------------------------------------------------------------------------------Interview Panel Comments -------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------

Interviewers Signature

N O . P G / 2 0 11 /

DECLARATION FORM
D E C L A R AT I O N B Y A P P L I C A N T W I T H C O M P O S I T E S C O R E
I N A N Y A I M A - M AT / C AT / X AT H E L D D U R I N G S e p 1 0 - M a y 11
(PLEASE READ NOTES BELOW CAREFULLY)
1. I had appeared in AIMA - MAT / CAT / XAT held in: (tick one) {IRS uses AIMA-MAT/CAT/XAT scores only for screening applicants for admissions}

September 2010

December 2010

February 2011

May 2011

Other
2

My composite score is:

(Attach copy of score card)

3. As per admission rules in the Prospectus 2011-12, I request to be waived the Written Admission Test:

Signature

Name

Yes

No

Date

Notes :
I. Applicants for PGDRM/PGPRM+MBA Programmes are entitled for waiver of Written Admission Test only if they are
eligible in the merit list prepared by IRS for any AIMA- MAT /CAT /XAT held during 2011-12. Such applicants will be called
for group discussions & personal interview directly.
II. It is open to an applicant of any of PG Programmes, with AIMA-MAT/CAT/XAT score, to not want waiver of Test, in such
case, applicant must clearly indicate.No in Serial No. 3 above.
III. Submission of this Declaration Form is compulsory for eligible applicants to obtain waiver of Test. In the absence of a
declaration or of copy of score card (serial no. 2 above) or of clear indication in Serial No. 3 above, applicant will have to
appear in Test.
IV. Decision to grant waiver of Test at Indian Retail School is not automatic.
V.

Applicants eligible for waiver of Test shall also fill in and submit ADMIT CARD along with APPLICATION FORM and
DECLARATION.

Admit Card
Post Graduate (Please tick in the relevant box )
[ ] Post Graduate Diploma in Retail Management* (1 year)
[ ] Post Graduate Programme in Retail & Marketing* + MBA** (2 years)
[ ] Post Graduate Diploma in Visual Merchandising and Store Design* (1 year)

Please affix

Under Graduate

passport size
[ ] Graduate Programme in Retail Business Studies* + BBA** (3 years)

photograph in
the box

Date of Examination

Time

: 10.00 am (be at the venue 15 minutes before this time)

Name

Phone No.

(to be filled by office)

Roll No.

Venue

: Indian Retail School

A-21/12, Naraina Industrial Area,
Phase-ll, New Delhi 110028
Signature of Examination Controller

* Autonomous Full Time Programme of IRS ** De gree through Distance Learning from a UGC recognized university *** Degree from University of Central Lancashire